Provider Demographics
NPI:1982172896
Name:RIVER BEND THERAPY, LLC
Entity type:Organization
Organization Name:RIVER BEND THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLINAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-581-0085
Mailing Address - Street 1:320 SW CENTURY DR STE 405-175
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3037
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:147 SW SHEVLIN HIXON DR STE 201
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1137
Practice Address - Country:US
Practice Address - Phone:415-465-2922
Practice Address - Fax:541-610-1884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health