Provider Demographics
NPI:1619774759
Name:EBB AND FLOW MENTAL HEALTH LLC
Entity type:Organization
Organization Name:EBB AND FLOW MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC, FNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:AURORA
Authorized Official - Last Name:SAPIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:541-648-7980
Mailing Address - Street 1:231 SW SCALEHOUSE LOOP STE 204
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1277
Mailing Address - Country:US
Mailing Address - Phone:541-648-7980
Mailing Address - Fax:
Practice Address - Street 1:231 SW SCALEHOUSE LOOP STE 204
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1277
Practice Address - Country:US
Practice Address - Phone:541-648-7980
Practice Address - Fax:541-391-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-26
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care