S Anandavalli, PHD, LPCA, NCC, CCTP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R6591 Issued in OR

Practice address

1133 NW Wall St Ste 1
Bend, OR 97703-1976

Phone

(971) 202-1927

NPI assigned

Jul 6, 2022

Last updated

Jul 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1780317966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4698 NE BEAUMEAD LN",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246664",
            "telephone_number": "620-238-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 NW WALL ST STE 1",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031976",
            "telephone_number": "971-202-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANANDAVALLI",
        "first_name": "S",
        "credential": "PHD, LPCA, NCC, CCTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R6591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Brent Amundson, D.M.D.
• Amy King LCSW LLC
• Amy Manion Family Therapy
• Rachel Anady
• Ananda Psychotherapy
• Amanda Cassandra Ananian, LCSW
• Joanna Alexandra Andaluz
• Andeen Counseling, LLC
• Adrienne Andeen, LCSW
• Kynlee Anderman

• 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 Jul 6, 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.