Individual provider Active NPI

Kym Leann Miller

  • Mental Health Counselor
  • Colville, WA
National Provider Identifier
1467699934
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60160475 Issued in WA
Practice address
165 E Hawthorne Ave
Colville, WA 99114-2629
Phone
(509) 685-0680
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MC60160475 WA Primary

Addresses

Primary practice location

165 E Hawthorne Ave
Colville, WA 99114-2629

Mailing address

165 E Hawthorne Ave
Colville, WA 99114-2629
Phone (509) 685-0680

Other names 1

  • Ms. Kym Leann O'Leary Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240612003183 WA Practitioner - Mental Health Counselor 2365984788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frontier Behavioral HealthGroup PAC ID 5092603340, 39 clinicians

Practice addresses (Care Compare)

107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC60160475WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Behavioral Health Mental Health CurrentSince Apr 22, 2024 Accepting new patients

Locations

107 S Division St
Spokane, WA 99202
Phone (509) 383-4651

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": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1467699934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 E HAWTHORNE AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142629",
            "telephone_number": "509-685-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E HAWTHORNE AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142629",
            "telephone_number": "509-685-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KYM",
        "middle_name": "LEANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60160475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYM",
            "last_name": "O'LEARY",
            "middle_name": "LEANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colville, WA

Sources for this page

Verify at the official NPI Registry.