Individual provider · Type 1 NPI

Ami Formica, MA, LPCA

Professional Counselor · Bend, OR

NPI number 1629990528 Active

Practice location

497 SW Century Dr Ste 102
Bend, OR 97702-1167

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XR9764 (OR)

Professional Counselor: Definition to come...

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About NPI 1629990528

Ami Formica, MA, LPCA's National Provider Identifier is 1629990528, issued on Jul 29, 2026. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bend, OR. The record was last updated on Jul 29, 2026.