Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1629990528 Individual Practitioner Female Practitioner

Ami Formica , MA, LPCA

Counselor - Professional • Bend, OR

Professional Overview & Biography Verified Profile Summary

Ami Formica, MA, LPCA is a registered healthcare professional specializing in Counselor - Professional in Bend, OR. Practice services are available at 497 SW CENTURY DR STE 102 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

497 Sw Century Dr Ste 102

Bend, OR 977021167

Telephone 2012330293
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Bend, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.8 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
214 Specialists

Practicing in Bend, OR (2601 Statewide)

Telehealth Adoption Rate
4.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-29
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License OR R9764

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Janet Mckee , MS, LPC, NCC

Counselor - Mental Health

NPI 1386761732

Master of Science, Licensed Professional Counselor, National Certified Counselor

Susan Kolb , MS, LPC

Counselor - Professional

NPI 1396829602

Master of Science, Licensed Professional Counselor

NPI 1457870552

Doctor of Psychology (Psy.D.)

Terri Merritt , LMFT

Marriage & Family Therapist

NPI 1629549746

Licensed Marriage and Family Therapist

Tracy Paul

Counselor - Mental Health

NPI 1780452011
Robin Vickery , LCSW

Social Worker - Clinical

NPI 1861684789

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 29, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location July 29, 2026

Registered at 497 SW CENTURY DR STE 102, BEND, OR 977021167 (Tel: 2012330293)

📍
Updated Business Mailing Address July 29, 2026

Registered at 497 SW CENTURY DR STE 102, BEND, OR 977021167 (Tel: 2012330293)

👤
Provider Name / Credentials Updated July 29, 2026

Recorded as AMI FORMICA, MA, LPCA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 29, 2026

Counselor (License #R9764 in OR)

🟢
Initial NPI Registration & Enumeration July 29, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1629990528
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 29, 2026
Last Update: July 29, 2026
Sole Proprietor: Yes

Mailing Address

497 Sw Century Dr Ste 102

Bend, OR 977021167

Phone: 2012330293

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.