Kristin Funk, M.A., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L4350 Issued in OR

Practice address

261 E 16TH Ave
Suite 2
Eugene, OR 97401-4105

Phone

(541) 579-1031

NPI assigned

May 2, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Kristin Funk Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 28, 2021 through Jul 28, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1255699880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 E 16TH AVE",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014105",
            "telephone_number": "541-579-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 E 16TH AVE",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014105",
            "telephone_number": "541-579-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "KRISTIN",
        "credential": "M.A., L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FUNK",
            "middle_name": "KRISTIN",
            "credential": "M.A., L.C.S.W.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Olivia Marie Fulton, CADC-R, QMHA-R
• Sherion Fulton
• Functional Foundations Pediatric Services
• Functional Foundations Pediatric Therapy PLLC
• Ernest Fung, PSY.D.
• Sandra Ellen Funk, FRA
• Garrett Ronald Funston, PHARMD.
• Kevin R Fura
• Furgason Fife Dentistry LLC
• James Michael Furgason, D.D.S.

• Clinical Social Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.