Breanna J. Montoya, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T1340 Issued in OR

Practice address

384 SW Upper Terrace Dr Ste 202
Bend, OR 97702-3432

Phone

(541) 788-9642

Fax

(651) 647-1413

NPI assigned

Apr 28, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Breanna J. Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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

• Core Foundations Counseling, LLC

  • Counselor
  • Bend, OR
  • NPI 1174176622
  NPD Authorized official

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1326213596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 NW BLACK PINES PL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031678",
            "telephone_number": "541-788-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 SW UPPER TERRACE DR STE 202",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023432",
            "telephone_number": "541-788-9642",
            "fax_number": "651-647-1413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61530 SE Stone Creek Lane",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "97702",
            "country_code": "US",
            "telephone_number": "541-355-6909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTOYA",
        "first_name": "BREANNA",
        "middle_name": "J.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500661132",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "JOHNSON",
            "middle_name": "J.",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine NMN Montgomery
• Courtney Paige Montgomery
• Jennifier Lynn Montgomery, DMD
• Mark Andrew Montgomery, L. AC.
• Angelina Montoya, M.D.
• Daniel Montoya, PA-C
• Isaac A Montoya
• Elizabeth Wertz Montserat, MSW, LCSW
• Cassidy Mooney
• Farren Ava Mooney

• Marriage & Family Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.