Individual provider Active NPI

Kristina Marie Meyers, LPC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1265790265
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C4216 Issued in OR
Practice address
4711 SW Huber St Ste 8
Portland, OR 97219-6862
Phone
(971) 319-4334
Fax
(971) 323-1123
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C4216 OR
Mental Health Counselor 101YM0800X C4216 OR Primary

Addresses

Primary practice location

4711 SW Huber St Ste 8
Portland, OR 97219-6862

Mailing address

4711 SW Huber St Ste 8
Portland, OR 97219-6862
Phone (971) 323-1121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260612000008 OR Order and Referring Only - Mental Health Counselor 6901378785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C4216ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alemana Counseling, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1265790265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 SW HUBER ST STE 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972196862",
            "telephone_number": "971-323-1121",
            "fax_number": "971-323-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 SW HUBER ST STE 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972196862",
            "telephone_number": "971-319-4334",
            "fax_number": "971-323-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4216",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C4216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.