Kiri Storm Watson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

4080 Reed Rd SE Ste 150
Salem, OR 97302-1335

Phone

(503) 581-1732

Fax

(503) 363-4607

NPI assigned

Jun 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Project Able, Inc.

  • Voluntary or Charitable Agency
  • Salem, OR
  • NPI 1568859593
  NPD (past)
• The Shangri-la Corporation

  dba Shangri-La Corporation

  • Community/Behavioral Health Agency
  • Eugene, OR
  • NPI 1053858993
  NPD (past)
• The Shangri-la Corporation

  dba Shangri-La Corporation

  • Community/Behavioral Health Agency
  • Salem, OR
  • NPI 1578000758
  NPD (past)

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1134797475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 TURNAGE ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973043516",
            "telephone_number": "503-949-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 REED RD SE STE 150",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021335",
            "telephone_number": "503-581-1732",
            "fax_number": "503-363-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1599 State St",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014255",
            "country_code": "US",
            "telephone_number": "503-363-3260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "398 High St",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974012310",
            "country_code": "US",
            "telephone_number": "541-344-1121 x101",
            "fax_number": "541-344-4780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "KIRI",
        "middle_name": "STORM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-14",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000104493",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Lyn Waters, LMT
• Amy Marie Watkins
• Cheyanne Elaine Watkins, LPN
• Kerry E. Watkins, M.D.
• Jesse L Watson, MA, CCSOT
• Kristen Watson, CADC II, QMHA
• Laura Evelyn Watson, RN
• Louanne Watson, CNM
• Stephanie Grace Watson
• Ann Watters, LMT #4867,RPP,RPE

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.