Individual provider Active NPI

Patricia Ann Kuehlem, LCPC, LMHC,CAP,CRADC

  • Professional Counselor
  • Vancouver, WA
National Provider Identifier
1184647554
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-005450 Issued in IL
Practice address
1601 East 4TH Plain Boulevard
Department of Veterans Affairs Medical Center V3-Satp
Vancouver, WA 98661
Phone
(360) 696-4061
Fax
(360) 737-1419
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180-005450 IL Primary
Professional Counselor 101YP2500X 60206734 WA

Addresses

Primary practice location

1601 East 4TH Plain Boulevard
Department of Veterans Affairs Medical Center V3-Satp
Vancouver, WA 98661

Mailing address

4304 NE 158TH PL
Vancouver, WA 98682-7191
Phone (360) 696-4061

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

State licenses

LicenseStateTypeSpecialty
180-005450ILMDProfessional Counselor
60206734WAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1184647554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4304 NE 158TH PL",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827191",
            "telephone_number": "360-696-4061",
            "fax_number": "360-737-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 EAST 4TH PLAIN BOULEVARD",
            "address_2": "DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER V3-SATP",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-696-4061",
            "fax_number": "360-737-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEHLEM",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC, LMHC,CAP,CRADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-005450",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "60206734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.