Active NPI
Kimberlee Diane Lear
- Mental Health Counselor
- Bend, OR
National Provider Identifier
1124553698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1569 SW Nancy Way Ste 1
Bend, OR 97702-3234 - Phone
- (541) 617-0377
- NPI assigned
- Apr 21, 2017
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1569 SW Nancy Way Ste 1
Bend, OR 97702-3234
Mailing address
878 NW Riverside Blvd
Bend, OR 97703-2547
Phone (541) 480-0863
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240910004067 | OR | Practitioner - Mental Health Counselor | 3779023304 | Practice locations: Bend, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
25 NW Park PL
Bend, OR 97703-2954
Phone (541) 480-0863
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1124553698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "878 NW RIVERSIDE BLVD",
"city": "BEND",
"state": "OR",
"postal_code": "977032547",
"telephone_number": "541-480-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1569 SW NANCY WAY STE 1",
"city": "BEND",
"state": "OR",
"postal_code": "977023234",
"telephone_number": "541-617-0377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAR",
"first_name": "KIMBERLEE",
"middle_name": "DIANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-21",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"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 Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.