Kristen Doecke, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3667 Issued in OR

Practice address

221 W N St
Springfield, OR 97477-2957

Phone

(317) 750-5713

NPI assigned

Dec 28, 2017

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1174030100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W N ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W N ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772957",
            "telephone_number": "317-750-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOECKE",
        "first_name": "KRISTEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doctors Emergency Room Corp. PC.
• Doctors Emergency Room Corp. PC.
• Kristen Dawn Dodd, PA-C
• Christine M Dodson, RN
• David Andrew Dodson, MA QMHP
• Cassandra Domask
• Elizabeth Anne Dominguez, PHD
• Norma A. Dominguez
• Erica Donnan, MD
• Michael David Donnan, MD

• Mental Health Counselor in Springfield, OR
• Providers in Springfield, 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 Dec 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.