Active NPI
Ashley Ann Clary, QMHP
- Mental Health Counselor
- Redmond, OR
National Provider Identifier
1114477973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2659 SW 4TH St Ste 102
Redmond, OR 97756 - Phone
- (541) 516-6334
- NPI assigned
- Oct 5, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | OR | ||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2659 SW 4TH St Ste 102
Redmond, OR 97756
Mailing address
2659 SW 4TH St Ste 102
Redmond, OR 97756-6406
Other practice location 1
1195 NW Wall St
Bend, OR 97703
Phone (541) 726-1465
Other practice location 2
1195 NW Wall St
Bend, OR 97703
Phone (541) 726-1465
Other practice location 3
2577 NE Courtney Dr
Bend, OR 97701-7752
Phone (541) 322-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 283234 | Medicaid | OR |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561507200000",
"number": "1114477973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2659 SW 4TH ST STE 102",
"city": "REDMOND",
"state": "OR",
"postal_code": "977566406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2659 SW 4TH ST STE 102",
"city": "REDMOND",
"state": "OR",
"postal_code": "97756",
"telephone_number": "541-516-6334"
}
],
"practiceLocations": [
{
"address_1": "1195 NW Wall St",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "97703",
"country_code": "US",
"telephone_number": "541-726-1465",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1195 NW Wall St",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "97703",
"country_code": "US",
"telephone_number": "541-726-1465",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2577 NE Courtney Dr",
"address_purpose": "LOCATION",
"city": "Bend",
"state": "OR",
"postal_code": "977017752",
"country_code": "US",
"telephone_number": "541-322-7500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLARY",
"first_name": "ASHLEY",
"middle_name": "ANN",
"credential": "QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-05",
"last_updated": "2019-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "283234",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.