Individual provider Active NPI

Rachael Marble Leary, MA, LPC

  • Professional Counselor
  • Redmond, OR
National Provider Identifier
1043638448
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C6420 Issued in OR
Practice address
2424 SW Pumice Ave
Redmond, OR 97756-6729
Phone
(541) 668-6141
Fax
(541) 236-0332
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 21-12-20128 OR
Mental Health Counselor 101YM0800X C6420 OR
Professional Counselor 101YP2500X C6420 OR Primary

Addresses

Primary practice location

2424 SW Pumice Ave
Redmond, OR 97756-6729

Mailing address

70 SW Century Dr Ste 100-5038
Bend, OR 97702-3557
Phone (541) 668-6141

Other practice location 1

70 SW Century Dr Ste 100-5038
Bend, OR 97702-3557
Phone (541) 668-6141

Other practice location 2

376 SW Bluff Dr Ste 2
Bend, OR 97702-1399
Phone (541) 668-6141

Other identifiers 2

IdentifierTypeStateIssuer
1043638448OtherNPI1
500672516MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328002211 OR Practitioner - Mental Health Counselor 4688011455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

376 SW Bluff Dr
Suite 2
Bend, OR 97702-1399
Phone (541) 668-6141

70 SW Century Dr
Suite 100 5038
Bend, OR 97702-3557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Marble Counseling & Consulting, LLC Addiction (Substance Use Disorder) CurrentSince Feb 2, 2024 Accepting new patients

Locations

376 SW Bluff Dr
Ste 2
Bend, OR 97702
Phone (541) 668-6141

70 SW Century Dr
Ste 1005038
Bend, OR 97702
Phone (541) 668-6141

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1043638448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SW CENTURY DR STE 100-5038",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023557",
            "telephone_number": "541-668-6141",
            "fax_number": "541-236-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 SW PUMICE AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977566729",
            "telephone_number": "541-668-6141",
            "fax_number": "541-236-0332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 SW Century Dr Ste 100-5038",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977023557",
            "country_code": "US",
            "telephone_number": "541-668-6141",
            "fax_number": "541-236-0332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "376 SW Bluff Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977021399",
            "country_code": "US",
            "telephone_number": "541-668-6141",
            "fax_number": "541-236-0332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEARY",
        "first_name": "RACHAEL",
        "middle_name": "MARBLE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "21-12-20128",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C6420",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI1",
            "identifier": "1043638448",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500672516",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

Verify at the official NPI Registry.