Provider Demographics
NPI:1700767720
Name:HERSHEY, ROBERT DALE
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DALE
Last Name:HERSHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63048 WOODBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-8699
Mailing Address - Country:US
Mailing Address - Phone:541-640-9589
Mailing Address - Fax:
Practice Address - Street 1:389 SW SCALEHOUSE CT STE 130
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3241
Practice Address - Country:US
Practice Address - Phone:541-306-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health