Individual provider Active NPI

Beverly Oh, LPC

  • Professional Counselor
  • Coeur D Alene, ID
National Provider Identifier
1083080949
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
2101 E Grandview Dr
Coeur D Alene, ID 83815-9547
Phone
(208) 660-6211
NPI assigned
Aug 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

2101 E Grandview Dr
Coeur D Alene, ID 83815-9547

Mailing address

2101 E Grandview Dr
Coeur D Alene, ID 83815-9547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20240606002255 ID Practitioner - Mental Health Counselor 1759823628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Wellness and Relationship Services LLCGroup PAC ID 5092106443, 8 clinicians

Practice addresses (Care Compare)

1110 W Park PL
Suite 303
Coeur D Alene, ID 83814-2784
Phone (208) 261-2255

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Wellness and Relationship Services LLC Mental Health CurrentSince May 1, 2024 Accepting new patients

Locations

1110 W Park Pl
Ste 303
Coeur D Alene, ID 83814
Phone (208) 261-2255

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": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1083080949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E GRANDVIEW DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E GRANDVIEW DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159547",
            "telephone_number": "208-660-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "BEVERLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.