Active NPI
Lea Cisero Blumberg, QMHP
- Mental Health Counselor
- Bend, OR
National Provider Identifier
1699355255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 21-QMHP-R-0608
- Practice address
- 908 NE 4TH St Ste 101
Bend, OR 97701-4646 - Phone
- (541) 617-7365
- NPI assigned
- Apr 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 21-QMHP-R-0608 | OR | Primary |
Addresses
Primary practice location
908 NE 4TH St Ste 101
Bend, OR 97701-4646
Mailing address
PO Box 1710
Redmond, OR 97756-0516
Phone (541) 516-4087
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 |
|---|---|---|---|
| 21-QMHP-R-0608 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617840000000",
"number": "1699355255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1710",
"city": "REDMOND",
"state": "OR",
"postal_code": "977560516",
"telephone_number": "541-516-4087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 NE 4TH ST STE 101",
"city": "BEND",
"state": "OR",
"postal_code": "977014646",
"telephone_number": "541-617-7365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CISERO BLUMBERG",
"first_name": "LEA",
"credential": "QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-08",
"last_updated": "2021-04-08",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "21-QMHP-R-0608",
"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 Apr 8, 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.