The Clinic for Emotional Wellness

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE CLINIC FOR EMOTIONAL WELLNESS

Practice address

23065 Bacchus LN
Bend, OR 97702-9298

Phone

(208) 681-6097

NPI assigned

Jul 28, 2023

Last updated

Jul 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Pettingill

Title

Ceo

Phone

(208) 681-6097

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1932880226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23065 BACCHUS LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029298",
            "telephone_number": "208-681-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23065 BACCHUS LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029298",
            "telephone_number": "208-681-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC FOR EMOTIONAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "PETTINGILL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-681-6097"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.