Kylie Jeane Bauer Frideres, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C4603 Issued in OR

Practice address

731 NW Franklin Ave Ste 107
Bend, OR 97703

Phone

(541) 306-1128

Fax

(541) 647-1162

NPI assigned

May 8, 2012

Last updated

May 15, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Cascade Counseling Services LLC

  • Professional Counselor
  • Bend, OR
  • NPI 1306298757
  NPD (past)

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1235498536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60748 RIVER BEND DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977027909",
            "telephone_number": "360-690-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 NW FRANKLIN AVE STE 107",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97703",
            "telephone_number": "541-306-1128",
            "fax_number": "541-647-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDERES",
        "first_name": "KYLIE",
        "middle_name": "JEANE BAUER",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C4603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123190",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillippe C Freeman, DMD, FAGD
• Gary John Frei, M.D.
• Brolen Freimanis, DDS
• Jessica Frenkel
• Jenny Fretland
• Joan Blum Friderici, MD
• Camryn Friedlaender
• Jason Alexander Friedman, DC
• Friends of the Children
• Friends of the Children Central Oregon

• Mental Health Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.