MEDICARE: ALPINE MEADOW COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1245173657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPINE MEADOW COUNSELING, LLC

Provider Business Mailing Address
First Line	:	3230 NW PRAIRIE PL
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-5519
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3230 NW PRAIRIE PL
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-5519
Country	:	US
Telephone Number	:	541-241-6605
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	HEATHER DUMSER
Credential	:
Telephone Number	:	541-241-6605

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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