Active NPI
Abigail Marie Shepherd Beyenberg, PHD
- Clinical Psychologist
- Wenatchee, WA
National Provider Identifier
1043617707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY61001510
- Practice address
- 600 Orondo Ave Ste 1
Wenatchee, WA 98801 - Phone
- (509) 662-6000
- Fax
- (509) 664-4589
- NPI assigned
- Nov 24, 2014
- Last updated
- Aug 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH60859345 | WA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | PY61001510 | WA | Primary |
Addresses
Primary practice location
600 Orondo Ave Ste 1
Wenatchee, WA 98801
Mailing address
600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone (509) 662-6000
Other practice location 1
900 Eastmont Ave
East Wenatchee, WA 98802-6602
Phone (509) 884-9000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2108400 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH60859345 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1043617707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 ORONDO AVE STE 1",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988012800",
"telephone_number": "509-662-6000",
"fax_number": "509-664-3589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 ORONDO AVE STE 1",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "98801",
"telephone_number": "509-662-6000",
"fax_number": "509-664-4589"
}
],
"practiceLocations": [
{
"address_1": "900 Eastmont Ave",
"address_purpose": "LOCATION",
"city": "East Wenatchee",
"state": "WA",
"postal_code": "988026602",
"country_code": "US",
"telephone_number": "509-884-9000",
"fax_number": "509-884-9001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHEPHERD BEYENBERG",
"first_name": "ABIGAIL",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-24",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60859345",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY61001510",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2108400",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wenatchee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.