Individual provider Active NPI

Rebecca Sophie Bobek, PSY.D.

  • Clinical Psychologist
  • Corvallis, OR
National Provider Identifier
1932357555
Registry record updated Mar 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2729 Issued in OR
Practice address
216 NW 6TH St
Corvallis, OR 97330-4812
Phone
(541) 740-9094
Fax
(541) 754-0477
NPI assigned
Sep 8, 2008
Last updated
Mar 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9699 MA
Clinical Psychologist 103TC0700X 2729 OR Primary

Addresses

Primary practice location

216 NW 6TH St
Corvallis, OR 97330-4812

Mailing address

216 NW 6TH St
Corvallis, OR 97330-4812
Phone (541) 740-9094

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
I20161129002294 OR Practitioner - Clinical Psychologist 7315181963 Practice locations: Corvallis, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

216 NW 6TH St
Corvallis, OR 97330-4812
Phone (541) 740-9094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
9699MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Aron, PSYD, MSW, PC CurrentSince Mar 20, 2022 Accepting new patients
Child and Family Psychological Services, PLLC Clinical PastSince Sep 19, 2018 Accepting new patients

Locations

216 NW 6th St
Corvallis, OR 97330
Phone (541) 754-1209

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647475200000",
    "number": "1932357555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 NW 6TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304812",
            "telephone_number": "541-740-9094",
            "fax_number": "541-754-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 NW 6TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304812",
            "telephone_number": "541-740-9094",
            "fax_number": "541-754-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBEK",
        "first_name": "REBECCA",
        "middle_name": "SOPHIE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9699",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.