Active NPI
Therese Poncy, M.S.W., C.S.W.A
- Social Worker
- Bend, OR
National Provider Identifier
1033384227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- A2808
- Practice address
- 1340 NW Wall St.
Bend, OR 97701-7638 - Phone
- (541) 330-4681
- Fax
- (541) 388-6617
- NPI assigned
- Apr 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | A2808 | OR | Primary |
Addresses
Primary practice location
1340 NW Wall St.
Bend, OR 97701-7638
Mailing address
2577 NE Courtney Dr
Bend, OR 97701-7638
Phone (541) 322-7500
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 |
|---|---|---|---|
| A2808 | OR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1033384227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2577 NE COURTNEY DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017638",
"telephone_number": "541-322-7500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 NW WALL ST.",
"city": "BEND",
"state": "OR",
"postal_code": "977017638",
"telephone_number": "541-330-4681",
"fax_number": "541-388-6617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONCY",
"first_name": "THERESE",
"credential": "M.S.W., C.S.W.A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": "A2808",
"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 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.