Active NPI
Kelli Huntington, CADC-I
- Addiction (Substance Use Disorder) Counselor
- Bend, OR
National Provider Identifier
1184941445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 3901428
- Practice address
- 461 NE Greenwood Ave
Ste a
Bend, OR 97701-4607 - Phone
- (541) 617-7365
- Fax
- (541) 312-6343
- NPI assigned
- Apr 27, 2010
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3901428 | OR | Primary |
Addresses
Primary practice location
461 NE Greenwood Ave
Ste a
Bend, OR 97701-4607
Mailing address
461 NE Greenwood Ave
Ste a
Bend, OR 97701-4607
Phone (541) 617-7365
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210831 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3901428 | OR | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272326400000",
"number": "1184941445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 NE GREENWOOD AVE",
"address_2": "STE A",
"city": "BEND",
"state": "OR",
"postal_code": "977014607",
"telephone_number": "541-617-7365",
"fax_number": "541-312-6343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "461 NE GREENWOOD AVE",
"address_2": "STE A",
"city": "BEND",
"state": "OR",
"postal_code": "977014607",
"telephone_number": "541-617-7365",
"fax_number": "541-312-6343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTINGTON",
"first_name": "KELLI",
"credential": "CADC-I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-27",
"last_updated": "2010-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "3901428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "210831",
"state": "OR"
}
],
"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 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.