MEDICARE: EQUINOX INTEGRATIVE 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1568396992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EQUINOX INTEGRATIVE COUNSELING LLC

Provider Business Mailing Address
First Line	:	19575 FISHER LAKE LN
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-9181
Country	:	US
Telephone Number	:	503-318-2335
Fax Number	:

Provider Business Practice Location Address
First Line	:	497 SW CENTURY DR STE 4
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97702-1167
Country	:	US
Telephone Number	:	503-318-2335
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICIAN
Name	:	DAVID M MACOMBER
Credential	:	LPC
Telephone Number	:	503-318-2335

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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