Individual
MS. BETH LOUISE BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC III, LPC
Contact information
Practice address
555 NW 5TH ST, CORVALLIS, OR 97330-6418
(541) 757-4121
Mailing address
PO BOX 579, CORVALLIS, OR 97339-0579
(541) 766-6238
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
07-R-16
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10963
AZ
101YP2500X
Professional Counselor
LPC
OR
101YP2500X
Professional Counselor
LPC-11732
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084198
AHCCCS #
AZ
01
—
50531 11292799-1A
BENTON COUNTY EMPLOYEE NUMBER
OR
Enumeration date
06/12/2006
Last updated
06/30/2008
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