Active NPI
Wild Edge Counseling LLC
- Professional Counselor
- Bend, OR
National Provider Identifier
1639075823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- WILD EDGE COUNSELING LLC
- Practice address
- 354 NE Greenwood Ave Ste 202
Bend, OR 97701-4632 - Phone
- (503) 688-3988
- NPI assigned
- Oct 15, 2026
- Last updated
- Oct 15, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Madison Cameron, LPC
- Title
- Owner
- Phone
- (503) 688-3988
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NU | Primary |
Addresses
Primary practice location
354 NE Greenwood Ave Ste 202
Bend, OR 97701-4632
Mailing address
60958 Snowbrush Dr
Bend, OR 97702-3152
Phone (503) 688-3988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1792022400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792022400000",
"number": "1639075823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60958 SNOWBRUSH DR",
"city": "BEND",
"state": "OR",
"postal_code": "977023152",
"telephone_number": "503-688-3988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "354 NE GREENWOOD AVE STE 202",
"city": "BEND",
"state": "OR",
"postal_code": "977014632",
"telephone_number": "503-688-3988"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILD EDGE COUNSELING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-15",
"last_updated": "2026-10-15",
"certification_date": "2026-10-15",
"status": "A",
"authorized_official_last_name": "CAMERON",
"authorized_official_first_name": "MADISON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-688-3988",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"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 Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.