Individual provider Active NPI

Billie Marie Travelstead

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1336897313
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
A12521 Issued in OR
Practice address
1400 High St Ste B2
Eugene, OR 97401-4192
Phone
(541) 600-2034
NPI assigned
Mar 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X A12521 OR Primary

Addresses

Primary practice location

1400 High St Ste B2
Eugene, OR 97401-4192

Mailing address

2864 NW 29TH St
Corvallis, OR 97330-3548
Phone (818) 448-1287

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260507003785 OR Practitioner - Clinical Social Worker 8426526427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1300 NW Harrison Blvd
Corvallis, OR 97330-6277

1857 NW Kings Blvd
Corvallis, OR 97330-1907

2864 NW 29TH St
Corvallis, OR 97330-3548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A12521ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Sky Counseling CurrentSince May 1, 2022 Accepting new patients
Willamette Sky Counseling CurrentSince Mar 20, 2022 Accepting new patients

Locations

1400 High St
Ste B2
Eugene, OR 97401
Phone (541) 600-2034

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1336897313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 NW 29TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303548",
            "telephone_number": "818-448-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HIGH ST STE B2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014192",
            "telephone_number": "541-600-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVELSTEAD",
        "first_name": "BILLIE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A12521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.