Anastasia Grace Leypoldt

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3594 Issued in OR

Practice address

1975 McPherson St Ste 2
North Bend, OR 97459-3482

Phone

(541) 751-2508

Fax

(541) 751-2661

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coos County Oregon

  • Clinic/Center
  • Coos Bay, OR
  • NPI 1811981053

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1285054072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 MCPHERSON ST",
            "address_2": "STE 2",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593482",
            "telephone_number": "541-751-2508",
            "fax_number": "541-751-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 MCPHERSON ST STE 2",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593482",
            "telephone_number": "541-751-2508",
            "fax_number": "541-751-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYPOLDT",
        "first_name": "ANASTASIA",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3594",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2066",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Lee, M.S., BCBA
• Jae Eun Lee, DDS
• Chelsea Lemmer
• Amy J Levin, QMHP, MRA
• Micah Levitt
• Lighthouse Wellness Institute Inc
• Marissa Colleen Lindsay
• Deidrie Lindsey
• Michelle Lintner
• Wendi Liszka, PHARMD

• Professional Counselor in North Bend, OR
• Providers in North Bend, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.