=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659961985
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WAYFINDER THERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2021
-----------------------------------------------------
Last Update Date | 01/20/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28845 WEATHERLY LN N
-----------------------------------------------------
City | SWEET HOME
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97386-9741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-714-3464
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 505
-----------------------------------------------------
City | SWEET HOME
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97386-0505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-714-3464
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. HEATHER WEBSTER-HENRY
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 541-714-3464
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------