Corine Bakazan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C6632 Issued in OR

Practice address

967 Park Ave NE
Salem, OR 97301-2839

Phone

(503) 583-2117

Fax

(888) 375-4308

NPI assigned

Jun 3, 2014

Last updated

Jun 27, 2024By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Core Practice LLC

  dba The Core Practice

  • Professional Counselor
  • Salem, OR
  • NPI 1083320220
  NPD
• Health Allies

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1346895984
  NPD (past)
• Tiffany Kettermann, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1003461740
  NPD (past)

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1518370956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 PARK AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012839",
            "telephone_number": "843-495-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 PARK AVE NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012839",
            "telephone_number": "503-583-2117",
            "fax_number": "888-375-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKAZAN",
        "first_name": "CORINE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "5501",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel James Bailly, MD
• Bethany Baird
• Triena Baird, CADC II
• Mikaela Baize, BEHAVIOR TECHNICIAN
• Goun Bak, DMD
• Andrew Baker, DMD
• Charles Baker, QMHA
• Geraldine Baker, RDH
• Rex Klein Baker II, MD
• Tarra Leani Baker, MSN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.