Active NPI
Beth Louise Bailey, CADC III, LPC
- Addiction (Substance Use Disorder) Counselor
- Corvallis, OR
National Provider Identifier
1164464277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LISAC-10963
- Practice address
- 555 NW 5TH St
Corvallis, OR 97330-6418 - Phone
- (541) 757-4121
- NPI assigned
- Jun 12, 2006
- Last updated
- Jun 30, 2008
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LISAC-10963 | AZ | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 07-R-16 | OR | |
| Professional Counselor | 101YP2500X | LPC-11732 | AZ | |
| Professional Counselor | 101YP2500X | LPC | OR |
Addresses
Primary practice location
555 NW 5TH St
Corvallis, OR 97330-6418
Mailing address
PO Box 579
Corvallis, OR 97339-0579
Phone (541) 766-6238
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50531 11292799-1A | Other | OR | BENTON COUNTY EMPLOYEE NUMBER |
| 084198 | Other | AZ | AHCCCS # |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LISAC-10963 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
| 07-R-16 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| LPC-11732 | AZ | MD | Professional Counselor |
| LPC | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214784000000",
"number": "1164464277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 579",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973390579",
"telephone_number": "541-766-6238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 NW 5TH ST",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973306418",
"telephone_number": "541-757-4121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "BETH",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "CADC III, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2008-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LISAC-10963",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "07-R-16",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-11732",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "LPC",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BENTON COUNTY EMPLOYEE NUMBER",
"identifier": "50531 11292799-1A",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS #",
"identifier": "084198",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.