Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ami Formica, MA, LPCA

Individual provider Professional Counselor · NPI 1629990528

Ami Formica, MA, LPCA is a Professional Counselor in Bend, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2026
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

497 SW Century Dr Ste 102
Bend, OR 97702-1167
Phone: (201) 233-0293
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence R9764 (OR)

Record details

NPI number1629990528
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , LPCA
Sole proprietorYes
NPI enumeratedJuly 29, 2026
Last updated in NPPESJuly 29, 2026
Certification dateJuly 29, 2026
Mailing address497 Sw Century Dr Ste 102, Bend, OR 97702-1167

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