LUTHERAN COMMUNITY SERVICES NW - BEND
NPI 1093074882
Counselor - Mental Health in Bend, OR
About Lutheran Community Services Nw - Bend NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LUTHERAN COMMUNITY SERVICES NW - BEND (NPI 1093074882) is a healthcare organization registered as a mental health in Bend, Oregon and active in the NPI registry since May 2012. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Daniel Johnston, Contract And Grant Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Other Identifiers 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lutheran Community Services Nw - Bend is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
20Medicare enrollment records show 20 clinicians reassign Medicare billing to Lutheran Community Services NW - Bend, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (20)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 38D2052869
Lutheran Community Services Northwest · Klamath Falls, ORFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lutheran Community Services NW's NPI number?
The NPI number for Lutheran Community Services NW is 1093074882. It was assigned to this organization in the NPPES registry on May 14, 2012. The provider is also known as Lutheran Community Services NW - Bend.
Where is Lutheran Community Services NW located?
Lutheran Community Services NW is located at 2330 NE Division St Ste 9B, Bend, OR 97703. The listed phone number is (541) 323-5333.
What is Lutheran Community Services NW's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Lutheran Community Services NW enrolled in Medicare?
Yes. Lutheran Community Services NW is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Lutheran Community Services NW?
According to the CMS Revalidation Reassignment List (October 2026 release), 20 clinicians in 5 Medicare specialties reassign their Medicare billing to Lutheran Community Services NW. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (8), Mental Health Counselor (7) and Nurse Practitioner (3). Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Lutheran Community Services NW hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 38D2052869) is associated with this NPI, valid through January 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Lutheran Community Services NW was last updated on October 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lutheran Community Services Nw - Bend · NPI 1093074882
Mental Health organization in Bend, Oregon. Organization record, active in the CMS NPPES registry since May 14, 2012.
## Identity
- **NPI:** 1093074882 (Entity type: Organization)
- **Enumerated:** May 14, 2012
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Legal business name:** Lutheran Community Services Nw
- **Organization subpart:** Yes (part of Lutheran Community Services Nw)
- **Authorized official:** Daniel Johnston, CONTRACT AND GRANT ADMINISTRATOR
## Practice location
- **Address:** 2330 NE DIVISION ST STE 9B, Bend, OR 97703-3530
- **Phone:** (541) 323-5333 · **Fax:** (541) 323-5854
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 20 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (8), Mental Health Counselor (7), Nurse Practitioner (3); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 15, 2019
- **Other identifiers:** Other 1093074882 (OR); Medicaid 500674445 (OR); Medicaid 283234 (OR)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1093074882) · Data from the CMS NPPES public registry.