Keith J Krueger, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

684 Issued in WA

Practice address

1812 Sumner Ave Ste I
Aberdeen, WA 98520-4602

Phone

(360) 532-5010

Fax

(360) 532-0061

NPI assigned

Feb 14, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Behavioral Counseling Associates PS

  • Psychologist
  • Aberdeen, WA
  • NPI 1215071717
  NPD (past)
• Richard P. Brooks, Jr., Arnp, Inc.

  dba Behavioral Healthcare Inc.

  • Psychiatric/Mental Health Registered Nurse
  • Hoquiam, WA
  • NPI 1659914000
  NPD (past)

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1083911812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 SUMNER AVE STE I",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204602",
            "telephone_number": "360-532-5010",
            "fax_number": "360-532-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 SUMNER AVE STE I",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204602",
            "telephone_number": "360-532-5010",
            "fax_number": "360-532-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "KEITH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Riley Ann Knutz
• Nicholas James Koch, M.D.
• Gary L Kolb, PHD
• Andrew Timothy Kowalski, D.O.
• Carol Marie Krueger, B.S.
• Annie Lamparzyk, CG 60505963
• Nancy Lamusga
• Lauren Nicole Land
• Daniel Charles Langer
• Alice J Larsen, MASTERS STUDENT

• Clinical Psychologist in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.