Midoregon Mental Health

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MIDOREGON MENTAL HEALTH

Practice address

131 NW Hawthorne Ave Ste 207
Bend, OR 97703-2958

Phone

(541) 460-5194

Fax

(541) 647-1331

NPI assigned

Mar 17, 2020

Organization subpart

No

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

Authorized official

Name

Lindsay D Shaver, M. ADMIN.

Title

Operations Director

Phone

(541) 460-5194

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1982230306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 NW HAWTHORNE AVE STE 207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032958",
            "telephone_number": "541-460-5194",
            "fax_number": "541-647-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 NW HAWTHORNE AVE STE 207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032958",
            "telephone_number": "541-460-5194",
            "fax_number": "541-647-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDOREGON MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "541-460-5194",
        "authorized_official_credential": "M. ADMIN."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerod Paul Michael, MS, CCC-SLP
• Steven J Michel, MD
• Michelle Colquhoun OT, LLC
• Mid-Oregon Counseling, LLC
• Susan C Middleton, LCSW
• Midtown Acupuncture
• Debra Tess Migdol, MA,LPC
• Robyn Ashley Migliorini, PHD
• Mikala L. Saccoman, PHD, LLC
• Kimberly Milbrandt, PSYD

• Clinical Psychologist in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.