Individual provider Active NPI

Nicole Elizabeth Landis, LMFT

  • Marriage & Family Therapist
  • Bend, OR
National Provider Identifier
1376905315
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1706 Issued in OR
Practice address
19570 Amber Meadow Dr Ste 150a
Bend, OR 97702-3531
Phone
(541) 728-3198
NPI assigned
Mar 28, 2016
Last updated
Sep 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 002693-01 NY
Marriage & Family Therapist 106H00000X T1706 OR Primary

Addresses

Primary practice location

19570 Amber Meadow Dr Ste 150a
Bend, OR 97702-3531

Mailing address

61813 SE Finn PL
Bend, OR 97702-8845
Phone (541) 728-3198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CG60306395WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Days Counseling Services, LLC CurrentSince May 7, 2023 Accepting new patients
WFM Healthcare, P.C. CurrentSince Feb 15, 2024 Accepting new patients
Sea Mar Community Health Centers Counselor PastSince Dec 1, 2019 Accepting new patients
Sound PastSince Oct 23, 2020 Accepting new patients

Locations

19570 Amber Meadow Dr
Ste 150A
Bend, OR 97702

2564 NE Courtney Dr
Bend, OR 97701
Phone (541) 678-5277

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1376905315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61813 SE FINN PL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977028845",
            "telephone_number": "541-728-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19570 AMBER MEADOW DR STE 150A",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023531",
            "telephone_number": "541-728-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "002693-01",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1706",
            "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 Sep 4, 2026; 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.