Individual provider Active NPI

Lauren Rene Bellenbaum, LPC

  • Mental Health Counselor
  • Grants Pass, OR
National Provider Identifier
1013276757
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
122 NE Beacon Dr
Grants Pass, OR 97526-3840
Phone
(541) 507-6400
Fax
(541) 500-0112
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Transform Youth and Family Counseling, LLC Mental Health CurrentSince Oct 10, 2021 Accepting new patients
Path to Awareness PC PastSince Nov 1, 2019 Accepting new patients

Locations

122 NE Beacon Dr
Grants Pass, OR 97526
Phone (541) 224-6821

777 NE 7th St
Ste 205
Grants Pass, OR 97526
Phone (541) 507-6400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

NPPES NPI Registry

Primary practice location

122 NE Beacon Dr
Grants Pass, OR 97526-3840

Mailing address

PO Box 4365
Medford, OR 97501-0168
Phone (541) 507-6400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 27, 2024.

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1013276757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4365",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010168",
            "telephone_number": "541-507-6400",
            "fax_number": "541-500-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NE BEACON DR",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975263840",
            "telephone_number": "541-507-6400",
            "fax_number": "541-500-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLENBAUM",
        "first_name": "LAUREN",
        "middle_name": "RENE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.