Active NPI
Karyn Smith
- Professional Counselor
- Bend, OR
National Provider Identifier
1053877035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C6131
- Practice address
- 60623 Devon Cir
Bend, OR 97702-9467 - Phone
- (541) 390-7810
- NPI assigned
- Feb 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C6131 | OR | Primary |
Addresses
Primary practice location
60623 Devon Cir
Bend, OR 97702-9467
Mailing address
60623 Devon Cir
Bend, OR 97702-9467
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 27, 2024 through Jun 27, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C6131 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1053877035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60623 DEVON CIR",
"city": "BEND",
"state": "OR",
"postal_code": "977029467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60623 DEVON CIR",
"city": "BEND",
"state": "OR",
"postal_code": "977029467",
"telephone_number": "541-390-7810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KARYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-14",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C6131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.