Kimberly Drew, M.A.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

R4207 Issued in OR

Practice address

754 NW Broadway St
Suite #207
Bend, OR 97703-2776

Phone

(541) 668-7558

Fax

(541) 526-3008

NPI assigned

Aug 4, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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 and National Provider Directory roles.

• Mirror Pond Counseling LLC

  • Counseling Psychologist
  • Bend, OR
  • NPI 1811531262

  Pastoral

  NPD (past) Authorized official

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1346794591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 NW BROADWAY ST",
            "address_2": "SUITE #207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032776",
            "telephone_number": "541-668-7558",
            "fax_number": "541-526-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 NW BROADWAY ST",
            "address_2": "SUITE #207",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032776",
            "telephone_number": "541-668-7558",
            "fax_number": "541-526-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "KIMBERLY",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R4207",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "OR",
            "license": "R4207",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "R4207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Piper Dreisbach, LCSW
• Madeline Drescher
• Khuelien Nguyen Dretke, NP
• Blake Brandt Drew, D.M.D
• Kathleen Drew
• Whitney K Drew, PA-C
• Aleah Driscoll, PA-C
• Chanda Maureen Driscoll, LCSW
• Driven Enterprises PC
• Robin Droege, LPCI

• Professional Counselor in Bend, OR
• Providers in Bend, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.