Active NPI
Beth Shiveley
- Professional Counselor
- Beaverton, OR
National Provider Identifier
1881041697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C4120
- Practice address
- 6365 SW Chestnut LN
Beaverton, OR 97005-4296 - Phone
- (503) 421-9119
- NPI assigned
- May 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C4120 | OR | Primary |
Addresses
Primary practice location
6365 SW Chestnut LN
Beaverton, OR 97005-4296
Mailing address
6365 SW Chestnut LN
Beaverton, OR 97005-4296
Phone (503) 421-9119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Sep 1, 2025 through Sep 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C4120 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763596800000",
"number": "1881041697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6365 SW CHESTNUT LN",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970054296",
"telephone_number": "503-421-9119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6365 SW CHESTNUT LN",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970054296",
"telephone_number": "503-421-9119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVELEY",
"first_name": "BETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-21",
"last_updated": "2025-11-20",
"certification_date": "2025-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C4120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.