Bend Embodied

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BEND EMBODIED

Practice address

825 SW Theater Dr
Bend, OR 97702-3509

Phone

(720) 442-4114

NPI assigned

Jun 5, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Autumn Stacey Marler, LPCANPI 1184386559

Title

Owner

Phone

(720) 442-4114

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Autumn Stacey Marler, LPC ASSOCIATE

  • Professional Counselor
  • Bend, OR
  • NPI 1184386559
  NPD Authorized official

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1316631138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SW THEATER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023509",
            "telephone_number": "720-442-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SW THEATER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023509",
            "telephone_number": "720-442-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEND EMBODIED",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "MARLER",
        "authorized_official_first_name": "AUTUMN",
        "authorized_official_middle_name": "STACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-442-4114",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPCA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bend Chiropractic Clinic, PC
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• Bend Dental Care, PC
• Bend Dermatology Clinic LLC
• Bend Dermatology Clinic LLC
• Bend Family Dentistry
• Bend Family Friends LLC
• Bend Family Therapy, LLC
• Bend Family Vision Care LLC
• Bend Grief and Trauma

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.