Mountain River Counseling and Consulting LLC

Primary specialty

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

Legal business name

MOUNTAIN RIVER COUNSELING AND CONSULTING LLC

Practice address

20273 Reed LN
Bend, OR 97702

Phone

(425) 654-0424

NPI assigned

Feb 3, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Edward Ewe, PHD

Title

Owner

Phone

(425) 654-0424

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 2

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

• Kelsey Pederson, LCSW

  • Clinical Social Worker
  • Turlock, CA
  • NPI 1831732114

  OR

  Medicare reassignment NPD
• Alanna Fraser, PCA

  • Mental Health Counselor
  • Bend, OR
  • NPI 1801779962
  NPD

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1356047047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61141 S HWY 97 # 226",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022523",
            "telephone_number": "425-654-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20273 REED LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "425-654-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIVER COUNSELING AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "EWE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-654-0424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500810109",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylie Danielle Motley
• Brian Mott, MD
• Marie Elise Moulton, MD
• Mountain Equinox LLC
• Mountain Medical Group LLC
• Mountain River Therapy, LLC
• Mountain View Acupuncture, LLC
• Mountain View Naturopathic Medicine, Inc.
• Mountain West Derm - Blackhart PLLC (Bend Dermatology Clinic)
• Move & Go Physio LLC

• 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 Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.