Individual provider · Type 1 NPI

Bren Wayside, QMHA-II, CRM-II, BSW

Mental Health Counselor · Medford, OR

NPI number 1407376932 Active

Practice location

140 S Holly St
Medford, OR 97501-3113

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XPROFESSIONALLICENSE

Mental Health Counselor: Definition to come...

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About NPI 1407376932

Bren Wayside, QMHA-II, CRM-II, BSW's National Provider Identifier is 1407376932, issued on Jun 26, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Medford, OR. The record was last updated on Sep 24, 2025.