Provider Demographics
NPI:1174176622
Name:CORE FOUNDATIONS COUNSELING, LLC
Entity type:Organization
Organization Name:CORE FOUNDATIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MONTOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:541-788-9642
Mailing Address - Street 1:384 SW UPPER TERRACE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3432
Mailing Address - Country:US
Mailing Address - Phone:541-788-9642
Mailing Address - Fax:641-647-1413
Practice Address - Street 1:384 SW UPPER TERRACE DR STE 202
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3432
Practice Address - Country:US
Practice Address - Phone:541-788-9642
Practice Address - Fax:541-647-1413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty