Carolyn Lucille Consoli

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW0001880 Issued in OR

Practice address

530 NW 27TH St
Corvallis, OR 97330-5223

Phone

(541) 766-6835

Fax

(541) 766-6186

NPI assigned

Aug 22, 2007

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063605095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NW 27TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305223",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NW 27TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305223",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hillmont Ave",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930031651",
            "country_code": "US",
            "telephone_number": "805-652-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONSOLI",
        "first_name": "CAROLYN",
        "middle_name": "LUCILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW0001880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500700084",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500732717",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert R Conniff, MSW
• Kambria Connor
• Fredmilg Conrado
• Angelina Conrow
• Jaya Conser Lapham, L.M.T.
• Catalina Contreras-Colin
• Joyce April Contreras
• Silvia G Contreras
• Jaime M Conway, MPAS, PA-C
• Katlynn Conway

• Peer Specialist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.