Organization
MIRROR POND COUNSELING LLC
Active
Other names
Mirror Pond Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DREW MA, LPC (OWNER)
(541) 668-7558
Entity
Organization
Contact information
Practice address
754 NW BROADWAY ST STE 207, BEND, OR 97703-2776
(541) 668-7558
Mailing address
754 NW BROADWAY ST STE 207, BEND, OR 97703-2776
(541) 668-7558
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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