Individual provider Active NPI

Terri Lynn Merritt, LMFT

  • Marriage & Family Therapist
  • Bend, OR
National Provider Identifier
1629549746
Registry record updated Oct 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1908
Practice address
497 SW Century Dr Ste 102
Bend, OR 97702-1167
Phone
(541) 896-1098
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C5631 OR
Marriage & Family Therapist 106H00000X T1908 Primary

Addresses

Primary practice location

497 SW Century Dr Ste 102
Bend, OR 97702-1167

Mailing address

497 SW Century Dr Ste 102
Bend, OR 97702-1167
Phone (541) 896-1098

Other identifiers 1

IdentifierTypeStateIssuer
500767302MedicaidOR

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

LicenseStateTypeSpecialty
C5631ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Family Counseling Mental Health Current Accepting new patients

Locations

497 SW Century Dr
Ste 102
Bend, OR 97702
Phone (541) 383-0803

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1629549746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 SW CENTURY DR STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021167",
            "telephone_number": "541-896-1098",
            "fax_number": "541-797-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 SW CENTURY DR STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021167",
            "telephone_number": "541-896-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRITT",
        "first_name": "TERRI",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5631",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "T1908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500767302",
            "state": "OR"
        }
    ],
    "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 Oct 31, 2021; 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.