Individual provider Active NPI

Ann M Krueger, MA

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1346551322
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R7814 Issued in OR
Practice address
1814 SE 30TH Ave
Portland, OR 97214-4935
Phone
(503) 481-8094
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC150184 OR
Mental Health Counselor 101YM0800X R7814 OR Primary

Addresses

Primary practice location

1814 SE 30TH Ave
Portland, OR 97214-4935

Mailing address

1814 SE 30TH Ave
Portland, OR 97214-4935
Phone (503) 481-8094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 6, 2025 through Jun 6, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
R7814ORMDMental Health Counselor
AC150184ORMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1346551322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 SE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144935",
            "telephone_number": "503-481-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 SE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144935",
            "telephone_number": "503-481-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "ANN",
        "middle_name": "M",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC150184",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R7814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.