NPIMap

Organization Active NPI

Deschutes County Juvenile Community Justice Department

  • Mental Health Counselor
  • Bend, OR
National Provider Identifier
1174392260
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DESCHUTES COUNTY JUVENILE COMMUNITY JUSTICE DEPARTMENT
Practice address
63360 NW Britta Street
Building 1
Bend, OR 97703
Phone
(541) 388-6671
NPI assigned
Dec 29, 2023
Last updated
Jun 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sandra Anderson
Title
Credentialing Specialist
Phone
(541) 322-7678

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

63360 NW Britta Street
Building 1
Bend, OR 97703

Mailing address

PO Box 6005
Bend, OR 97708-6005
Phone (541) 388-6671

National Provider Directory

National Provider Directory
Tax ID family
Deschutes Co Mental HLT12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

63360 Britta St
Ste 1
Bend, OR 97703
Phone (541) 318-4845

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1174392260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6005",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086005",
            "telephone_number": "541-388-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63360 NW BRITTA STREET",
            "address_2": "BUILDING 1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97703",
            "telephone_number": "541-388-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESCHUTES COUNTY JUVENILE COMMUNITY JUSTICE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "541-322-7678"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.