Hendrix, Keith Jacob

Hendrix, Keith Jacob is an sole proprietor health care provider with primary practice located at 45 Nw Greeley Ave , Bend OR 97703-2943. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Hendrix, Keith Jacob can be contacted via phone (503) 616-1236.

Contact Information

Primary practice address
45 Nw Greeley Ave Bend OR 97703-2943
Phone: (503) 616-1236
Fax: (855) 305-5252
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X C1799 Oregon
Behavioral Health & Social Service Providers / Professional 101YP2500X C1799 Oregon

Profile Details

NPI number 1861662751
LBN Legal business name Hendrix, Keith Jacob
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2008
Last updated Nov 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1861662751 NPPES
Oregon MEDICAID 123190

Popular Providers