Individual provider Active NPI

Terri J Beachler

  • Mental Health Counselor
  • Bend, OR
National Provider Identifier
1073905410
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2480 NE Twin Knolls Dr
Bend, OR 97701-6833
Phone
(458) 292-8122
NPI assigned
Feb 23, 2015
Last updated
Feb 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X C4676 OR

Addresses

Primary practice location

2480 NE Twin Knolls Dr
Bend, OR 97701-6833

Mailing address

2480 NE Twin Knolls Dr
Bend, OR 97701-6833
Phone (458) 292-8122

Other practice location 1

365 NE Court St
Prineville, OR 97754-1936
Phone (541) 323-5330

Other identifiers 1

IdentifierTypeStateIssuer
283234MedicaidOR

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
I20250605001439 OR Practitioner - Mental Health Counselor 3375052707 Practice locations: Prineville, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C4676ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Community Services Northwest Past Accepting new patients
M3 Alliance LLC PastSince Oct 24, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1073905410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 NE TWIN KNOLLS DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016833",
            "telephone_number": "458-292-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 NE TWIN KNOLLS DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016833",
            "telephone_number": "458-292-8122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "365 NE Court St",
            "address_purpose": "LOCATION",
            "city": "Prineville",
            "state": "OR",
            "postal_code": "977541936",
            "country_code": "US",
            "telephone_number": "541-323-5330",
            "fax_number": "541-447-6694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEACHLER",
        "first_name": "TERRI",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4676",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283234",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.