Active NPI
Kathryn Shreve
- Counselor
- Bend, OR
National Provider Identifier
1205195740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 20370 Poe Sholes Dr
Bend, OR 97701-7938 - Phone
- (541) 318-1377
- NPI assigned
- May 3, 2012
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
20370 Poe Sholes Dr
Bend, OR 97701-7938
Mailing address
20370 Poe Sholes Dr
Bend, OR 97701-7938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 14, 2024 through Feb 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17159 | NC | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mend Counseling Services PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Fayetteville, NC
- NPI 1487287686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1205195740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20370 POE SHOLES DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20370 POE SHOLES DR",
"city": "BEND",
"state": "OR",
"postal_code": "977017938",
"telephone_number": "541-318-1377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHREVE",
"first_name": "KATHRYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-03",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.