Shannon Janelle Liebel

Primary specialty

CounselorTaxonomy code 101Y00000X

License

R9433 Issued in OR

Practice address

754 NW Broadway St Ste 207
Bend, OR 97703-2776

Phone

(541) 668-7558

NPI assigned

Jul 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mirror Pond Counseling LLC

  • Counseling Psychologist
  • Bend, OR
  • NPI 1811531262
  NPD

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1932945730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19748 DRY CANYON AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023961",
            "telephone_number": "619-246-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 NW BROADWAY ST STE 207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032776",
            "telephone_number": "541-668-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBEL",
        "first_name": "SHANNON",
        "middle_name": "JANELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "R9433",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "R9433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Shepherd Lewis Jr., M.D.
• Sarah Hanigan Lewis
• Suhan Li, MD
• Kristin M Liabraaten, CD(DONA), HCHI
• Clara Rose Liberov
• Stephanie Liebelt, LMT
• Leah Lieber, D.O.
• Bari Liebowitz, DC
• Brandon W Lien, CADC-I
• Liesl Farnsworth, PHD, LPC

• Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2024; 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.