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Individual

BRENNON PATRICK MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC-II, LPC, LMHC

Contact information

Practice address
19570 AMBER MEADOW DR STE 120, BEND, OR 97702-3530
(541) 980-7542
Mailing address
2998 NE RAINIER DR, BEND, OR 97701-7763
(541) 980-7542

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3918
OR
101YM0800X
Mental Health Counselor
LH60571272
WA

Other

Enumeration date
07/12/2016
Last updated
02/20/2026
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