Blue Iris River Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE IRIS RIVER COUNSELING LLC

Practice address

2460 4TH St NE
Salem, OR 97301-8332

Phone

(503) 559-8831

NPI assigned

Aug 15, 2022

Organization subpart

No

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

Authorized official

Name

Terry Banta, LCSWNPI 1386280352

Title

Social Worker

Phone

(503) 559-8831

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry Denise Banta, CSWA

  • Clinical Social Worker
  • Salem, OR
  • NPI 1386280352
  NPD Authorized official

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1831817055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 4TH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 4TH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018332",
            "telephone_number": "503-559-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE IRIS RIVER COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "BANTA",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "503-559-8831",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lynette Careen Bloom, CADC I
• Bloomer Counseling and Consulting, Inc.
• Tanya Ann Bloomfield
• Blossom Psychiatric Care LLC
• Kaylyn Marie Blum, ATC
• Lenshina M Blume, PMHNP
• Leonardo Bobadilla, PH.D
• Jordan Bobb, RDH, EPDH
• Emily C Bobbitt, LMT

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.