NPIMap

Individual provider Active NPI

Bethany Ann O'Neill, PSY.D.

  • Psychologist
  • Bellevue, WA
National Provider Identifier
1871681981
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60234792 Issued in WA
Practice address
365 118TH Street SE
#118
Bellevue, WA 98005
Phone
(206) 381-1100
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20050389109 MO
Psychologist 103T00000X PY60234792 WA Primary

Addresses

Primary practice location

365 118TH Street SE
#118
Bellevue, WA 98005

Mailing address

210 E Blaine St.
Apartment #309
Seattle, WA 98102
Phone (417) 766-7008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20050389109MOMDPsychologist
PY60234792WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Health Center, PC Psychologist PastSince Jul 16, 2009 Accepting new patients

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1871681981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E BLAINE ST.",
            "address_2": "APARTMENT #309",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98102",
            "telephone_number": "417-766-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 118TH STREET SE",
            "address_2": "#118",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "206-381-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "BETHANY",
        "middle_name": "ANN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "20050389109",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60234792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.