Individual
WHITNEY BLACKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1435 NE 4TH ST, BEND, OR 97701-4200
(541) 904-5216
Mailing address
7515 FALCON CREST DR # 200, REDMOND, OR 97756-5014
(541) 904-5216
(541) 527-4347
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C9671
OR
106S00000X
Behavior Technician
ABA-IN-10203718
OR
Other
Enumeration date
10/14/2019
Last updated
03/10/2026
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