Annette Korkeakoski-Sears

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

388 State St Ste 702
Salem, OR 97301-3866

Phone

(503) 577-7358

NPI assigned

Jul 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Marion County

  • Methadone Clinic
  • Salem, OR
  • NPI 1386706919
  NPD
• Marion County

  • Adult Mental Health Clinic/Center
  • Salem, OR
  • NPI 1528147782
  NPD

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507507200000",
    "number": "1386808020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3876 BEVERLY AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051319",
            "telephone_number": "503-763-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 STATE ST STE 702",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013866",
            "telephone_number": "503-577-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORKEAKOSKI-SEARS",
        "first_name": "ANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-11",
        "last_updated": "2017-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ann Callery Koontz, RN, LMT
• Madelyn Jo Koontz, RD, LD
• Tara Jade Koretsky, PHARM.D.
• Kori Chancellor Counseling
• Kori Chancellor Counseling
• Laurel Ann Taylor Kornblau
• George Kosboth II, M.A.
• Julie R. Kosker
• Kosmos Psychology
• Kat Kosmos, PSYD

• Mental Health Counselor in Salem, OR
• Providers in Salem, 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 Oct 9, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.