Individual provider Active NPI

Beth Louise Bailey, CADC III, LPC

  • Addiction (Substance Use Disorder) Counselor
  • Corvallis, OR
National Provider Identifier
1164464277
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LISAC-10963 Issued in AZ
Practice address
555 NW 5TH St
Corvallis, OR 97330-6418
Phone
(541) 757-4121
NPI assigned
Jun 12, 2006
Last updated
Jun 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
50531 11292799-1AOtherORBENTON COUNTY EMPLOYEE NUMBER
084198OtherAZAHCCCS #

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

LicenseStateTypeSpecialty
LISAC-10963AZMDAddiction (Substance Use Disorder) Counselor
07-R-16ORMDAddiction (Substance Use Disorder) Counselor
LPC-11732AZMDProfessional Counselor
LPCORMDProfessional 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.

Verify at the official NPI Registry.