Active NPI
Kimberly Ann Reilly, MA, CAGS
- Mental Health Counselor
- Ashland, OR
National Provider Identifier
1184165342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 735 Grandview Dr
Ashland, OR 97520-1674 - Phone
- (541) 603-8603
- NPI assigned
- Mar 20, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | OR |
Addresses
Primary practice location
735 Grandview Dr
Ashland, OR 97520-1674
Mailing address
PO Box 1182
Ashland, OR 97520-0040
Phone (541) 603-8603
Other practice location 1
1221 Lakeshore Dr
Port Orford, OR 97465-9584
Phone (541) 200-4741
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C9763 | Other | OR | OBLPC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762473600000",
"number": "1184165342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1182",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975200040",
"telephone_number": "541-603-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "735 GRANDVIEW DR",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201674",
"telephone_number": "541-603-8603"
}
],
"practiceLocations": [
{
"address_1": "1221 Lakeshore Dr",
"address_purpose": "LOCATION",
"city": "Port Orford",
"state": "OR",
"postal_code": "974659584",
"country_code": "US",
"telephone_number": "541-200-4741",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REILLY",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MA, CAGS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-20",
"last_updated": "2025-11-07",
"certification_date": "2025-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OBLPC",
"identifier": "C9763",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.