Active NPI
Mary Thornburg Krug, MS, LPC
- Counselor
- Portland, OR
National Provider Identifier
1205039633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C 2231
- Practice address
- 2100 NE Broadway St
Suite 101
Portland, OR 97232-1569 - Phone
- (503) 449-9729
- Fax
- (503) 287-2801
- NPI assigned
- Jun 5, 2007
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | C 2231 | OR | Primary |
Addresses
Primary practice location
2100 NE Broadway St
Suite 101
Portland, OR 97232-1569
Mailing address
2100 NE Broadway St
Suite 101
Portland, OR 97232-1569
Phone (503) 449-9729
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C 2231 | OR | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401062400000",
"number": "1205039633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 NE BROADWAY ST",
"address_2": "SUITE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321569",
"telephone_number": "503-449-9729",
"fax_number": "503-287-2801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 NE BROADWAY ST",
"address_2": "SUITE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321569",
"telephone_number": "503-449-9729",
"fax_number": "503-287-2801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUG",
"first_name": "MARY",
"middle_name": "THORNBURG",
"name_prefix": "Ms.",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-05",
"last_updated": "2014-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "C 2231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.