Tracy Anderman

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Practice address

61850 Dobbin Rd
Bend, OR 97702-9536

Phone

(541) 389-1985

NPI assigned

Jan 18, 2024

Last updated

Jan 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Youth Discovery

  dba Northwest Discovery

  • Mental Health Counselor
  • Bend, OR
  • NPI 1245779354
  NPD (past)
• Northwest Youth Discovery

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bend, OR
  • NPI 1275085128

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD (past)

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1184485922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 NW YOSEMITE DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977036722",
            "telephone_number": "541-610-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61850 DOBBIN RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029536",
            "telephone_number": "541-389-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERMAN",
        "first_name": "TRACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Cassandra Ananian, LCSW
• Joanna Alexandra Andaluz
• Andeen Counseling, LLC
• Adrienne Andeen, LCSW
• Kynlee Anderman
• Matthew Andermann
• Amy M Andersen
• Miah Andersen
• Amy Michelle Anderson
• Bryon Anderson

• Emotionally Disturbed Childrens' Residential Treatment Facility in Bend, OR
• Providers in Bend, OR by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.