Individual provider Active NPI

Karyn Elizabeth Defoe, LPC

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1003285073
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C7095 Issued in OR
Practice address
2411 Martin Luther King Jr Blvd
Eugene, OR 97401-5824
Phone
(541) 682-3608
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C7095 OR Primary

Addresses

Primary practice location

2411 Martin Luther King Jr Blvd
Eugene, OR 97401-5824

Mailing address

3405 Voight PL
Saginaw, MI 48603-2362
Phone (989) 890-7125

Other names 1

  • Karyn Elizabeth Bate-Defoe, Aguilera Former name

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
I20240125004397 OR Practitioner - Mental Health Counselor 7719330737 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lane County Oregon CurrentSince Jan 1, 2024 Accepting new patients
Victory Clinical Services IV, LLC PastSince Jun 2, 2012 Accepting new patients

Locations

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-3551

2411 Martin Luther King Jr Blvd
Eugene, OR 97401
Phone (541) 682-3608

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Interoperability endpoints

  • Direct secure messaging: karyn.defoe.p1@direct.lanecounty.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1003285073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 VOIGHT PL",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032362",
            "telephone_number": "989-890-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 MARTIN LUTHER KING JR BLVD",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015824",
            "telephone_number": "541-682-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFOE",
        "first_name": "KARYN",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C7095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARYN",
            "last_name": "BATE-DEFOE, AGUILERA",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.