Elizabeth Chappellet Omlid, MS

Key facts

NPI

1629533377

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

1655 SW Highland Ave Ste 3
Redmond, OR 97756-2558

Phone

(541) 923-2654

NPI assigned

Feb 6, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

Specialties & licenses

Addresses

Other names

• Libby Chappellet Walker Professional name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 6, 2019.

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1629533377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20718 TOWN DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977018283",
            "telephone_number": "541-480-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 SW HIGHLAND AVE STE 3",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562558",
            "telephone_number": "541-923-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMLID",
        "first_name": "ELIZABETH",
        "middle_name": "CHAPPELLET",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIBBY",
            "last_name": "WALKER",
            "middle_name": "CHAPPELLET",
            "credential": "MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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