Abigail Bruntlett, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C7022 Issued in OR

Practice address

1005 SW Disk Dr Ste 104
Bend, OR 97702-3385

Phone

(541) 316-5574

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1760918619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 535",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977090535",
            "telephone_number": "541-214-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 SW DISK DR STE 104",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023385",
            "telephone_number": "541-316-5574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1714 NW Quincy Ave",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977031455",
            "country_code": "US",
            "telephone_number": "541-316-5574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNTLETT",
        "first_name": "ABIGAIL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7022",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C7022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Ann Bryan, QMHP
• Bryant Vette LCSW LLC

• Mental Health Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.