Individual provider Active NPI

Laurie J Wittich

  • Professional Counselor
  • Baker City, OR
National Provider Identifier
1578933909
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C7897 Issued in OR
Practice address
3425 13TH St
Baker City, OR 97814-1340
Phone
(541) 523-7400
Fax
(541) 523-4927
NPI assigned
Sep 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 19-QMHPC-00903 OR
Professional Counselor 101YP2500X C7897 OR Primary

Addresses

Primary practice location

3425 13TH St
Baker City, OR 97814-1340

Mailing address

3425 13TH St
Baker City, OR 97814-1340
Phone (541) 523-7400

Other identifiers 2

IdentifierTypeStateIssuer
500699838MedicaidOR
4559332OtherORODL

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
I20240605001705 OR Practitioner - Mental Health Counselor 6305388364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Directions Northwest IncGroup PAC ID 0446572721, 8 clinicians

Practice addresses (Care Compare)

3425 13TH St
Baker City, OR 97814-1340
Phone (541) 523-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19-QMHPC-00903ORMDMental Health Counselor
C7897ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Directions Northwest, Inc CurrentSince May 1, 2024 Accepting new patients

Locations

2200 4th St
Baker City, OR 97814
Phone (541) 523-3646

3610 Midway Dr
Baker City, OR 97814
Phone (541) 523-6581

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1578933909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 13TH ST",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141340",
            "telephone_number": "541-523-7400",
            "fax_number": "541-523-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTICH",
        "first_name": "LAURIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "19-QMHPC-00903",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500699838",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODL",
            "identifier": "4559332",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker City, OR

Sources for this page

Verify at the official NPI Registry.