Active NPI
Bethany Ingram
- Clinical Social Worker
- Salem, OR
National Provider Identifier
1922448406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 2355 State St Ste 101
Salem, OR 97301-4541 - Phone
- (503) 427-8104
- Fax
- (503) 447-8676
- NPI assigned
- Jun 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
2355 State St Ste 101
Salem, OR 97301-4541
Mailing address
PO Box 96022
Portland, OR 97296-6000
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1922448406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 96022",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972966000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 STATE ST STE 101",
"city": "SALEM",
"state": "OR",
"postal_code": "973014541",
"telephone_number": "503-427-8104",
"fax_number": "503-447-8676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGRAM",
"first_name": "BETHANY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-28",
"last_updated": "2023-03-09",
"certification_date": "2023-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.