Active NPI
Brennon Patrick Moore, CADC-II, LPC, LMHC
- Mental Health Counselor
- Bend, OR
National Provider Identifier
1023460102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C3918
- Practice address
- 19570 Amber Meadow Dr Ste 120
Bend, OR 97702-3530 - Phone
- (541) 980-7542
- NPI assigned
- Jul 12, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C3918 | OR | Primary |
Addresses
Primary practice location
19570 Amber Meadow Dr Ste 120
Bend, OR 97702-3530
Mailing address
2998 NE Rainier Dr
Bend, OR 97701-7763
Phone (541) 980-7542
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C3918 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1023460102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2998 NE RAINIER DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017763",
"telephone_number": "541-980-7542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19570 AMBER MEADOW DR STE 120",
"city": "BEND",
"state": "OR",
"postal_code": "977023530",
"telephone_number": "541-980-7542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "BRENNON",
"middle_name": "PATRICK",
"credential": "CADC-II, LPC, LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-12",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C3918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.