SECOND WIND MENTAL HEALTH CLINIC (NPI# 1679957708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679957708 |
| Entity Type | Organization |
| Organization Name | SECOND WIND MENTAL HEALTH CLINIC |
| Practice Address |
11 Sw Brantley Drive Winston OR 97496 |
| Practice Telephone | 5416790366 |
| Practice Fax Number | 5416794821 |
| Mailing Telephone | 5416790366 |
| Mailing Fax Number | 5416794821 |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-11-13 |
| Authorized Official Name | TAMARA LEE (SINGLE MEMBER LLC) |
| Authorized Official Telephone | 5416790366 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
200550033NP | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 363LP0808X | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SECOND WIND MENTAL HEALTH CLINIC L.L.C. | 11 Sw Brantley Dr, Winston, OR 97496 |
| Street Address |
11 SW BRANTLEY DRIVE |
| City | WINSTON |
| State | OR |
| Zip Code | 97496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992951305 | Ronald Forrest Tribble | Dentist | 90 Nw Glenhart, Winston, OR 97496 | 2008-08-18 |
| 1396923884 | Karen S Triplett | Nurse Practitioner | 92 Nw Glenhart Ave, Winston, OR 97496 | 2008-02-06 |
| 1629168166 | Adolescent Day Treatment Center Inc of Douglas County | Clinic/Center | 671 S.w. Main, Winston, OR 97496 | 2006-10-13 |
| 1184610123 | Ronald F. Tribble, Dmd, PC | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496 | 2005-09-26 |
| 1083016695 | Cora G Hart | Psychologist | 671 Sw Main St, Winston, OR 97496 | 2014-09-25 |
| 1912160169 | Kathryn Elizabeth Dailey | Social Worker | 671 Sw Main, Winston, OR 97496 | 2008-07-08 |
| 1912061755 | Adapt | Family Medicine | 671 Sw Main, Winston, OR 97496-0012 | 2006-12-19 |
| 1144426271 | Rebecca Lin Duffy | Nurse Practitioner | 311 Sw Main, Winston, OR 97496-0771 | 2007-06-25 |
| 1861843310 | Stacy J Nielsen, Lcsw, LLC | Community/Behavioral Health | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2016-06-27 |
| 1033462866 | Kathryn Vara | Registered Nurse | 77 Sw Brantley Dr, Winston, OR 97496-4526 | 2012-10-17 |
| Find all providers in zip 97496 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1124637236 | Inner Light Counseling & Bodywork LLC | Clinic/Center | 2520 Chaucer Ct, Eugene, OR 97405-1217 | 2020-07-24 |
| 1386269637 | Tending The Vineyard | Clinic/Center | 127 Nw Highway 99w, Mcminnville, OR 97128 | 2020-06-12 |
| 1912521998 | The Practice of Jeffery Wise Therapeutics Pmhnp-bc | Clinic/Center | 2651 Nw Thurman St Apt 303, Portland, OR 97210-2327 | 2020-06-04 |
| 1326661448 | Kgk Therapeutic Services | Clinic/Center | 1138 Jefferson St, Eugene, OR 97402-5246 | 2020-05-22 |
| 1831723642 | Wild River Counseling and Consultation, LLC | Clinic/Center | 107 E Main St Ste 7, Medford, OR 97501-6022 | 2020-03-02 |
| 1356973010 | Holistic Healing Behavioral Healthcare | Clinic/Center | 5257 Ne Martin Luther King Blvd Ste 201, Portland, OR 97211-3283 | 2020-02-10 |
| 1336786730 | Sarah Kaufman Counseling | Clinic/Center | 492 E 13th Ave Ste 210, Eugene, OR 97401-4268 | 2019-12-04 |
| 1942845805 | I. Keith Orton, Phd | Clinic/Center | 745 Nw Mt Washington Dr Ste 301, Bend, OR 97703-1576 | 2019-11-14 |
| 1407408305 | Adaptability for Life LLC | Clinic/Center | 309 N 1st St, Silverton, OR 97381-1605 | 2019-07-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.