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

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

Individual provider Mental Health Counselor · NPI 1407376932

Bren Wayside, QMHA-II, CRM-II, BSW is a Mental Health Counselor in Medford, Oregon. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

140 S Holly St
Medford, OR 97501-3113
Phone: (541) 774-8200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence PROFESSIONALLICENSE

Record details

NPI number1407376932
Entity typeIndividual (Type 1)
GenderFemale
Credentials QMHA-II , CRM-II , BSW
Sole proprietorNo
NPI enumeratedJune 26, 2017
Last updated in NPPESSeptember 24, 2025
Certification dateSeptember 24, 2025

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