Elizabeth Mary Bogdon, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C4160 Issued in OR

Practice address

2225 NE MLK Jr Blvd
Ste 207
Portland, OR 97212-3727

Phone

(971) 284-7313

NPI assigned

Jun 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Beth Mary Bogdon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Beth Bogdon LPC LLC

  • Community/Behavioral Health Agency
  • Portland, OR
  • NPI 1366995516
  NPD (past)

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469318400000",
    "number": "1497169841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 N WILLIS BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177264",
            "telephone_number": "971-284-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 NE MLK JR BLVD",
            "address_2": "STE 207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123727",
            "telephone_number": "971-284-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDON",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2016-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C4160",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60460126",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60480487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "BOGDON",
            "middle_name": "MARY",
            "prefix": "MRS.",
            "credential": "MA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Courtney Marie Bogart
• Vijayalaxmi Bogavelli, M.D.
• Donatella Bogdan, RN
• Lidiya Bogdan, LD
• Robyn Sue Bogden, PT
• Haley Katherine Boge
• Elisa Boggs
• Elsie Bogle, MSW, CSWA
• Mary Bogle
• Marta Bogrand, OTL

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2016; 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.