Active NPI
Brian John Bulemore, LPC, NCC, CADC-III
- Professional Counselor
- Bend, OR
National Provider Identifier
1609135136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C1953
- Practice address
- 115 NW Oregon Ave
Suite 20
Bend, OR 97701-2741 - Phone
- (541) 639-4499
- Fax
- (888) 770-8838
- NPI assigned
- May 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 06-03-61 | OR | |
| Professional Counselor | 101YP2500X | C1953 | OR | Primary |
Addresses
Primary practice location
115 NW Oregon Ave
Suite 20
Bend, OR 97701-2741
Mailing address
PO Box 1736
Bend, OR 97709-1736
Phone (541) 639-4499
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1953 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1609135136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1736",
"city": "BEND",
"state": "OR",
"postal_code": "977091736",
"telephone_number": "541-639-4499",
"fax_number": "888-770-8838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 NW OREGON AVE",
"address_2": "SUITE 20",
"city": "BEND",
"state": "OR",
"postal_code": "977012741",
"telephone_number": "541-639-4499",
"fax_number": "888-770-8838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULEMORE",
"first_name": "BRIAN",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "LPC, NCC, CADC-III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-03",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "06-03-61",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C1953",
"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 May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.