NPIMap

Individual provider Active NPI

Kimberly McLeer

  • Addiction (Substance Use Disorder) Counselor
  • Salem, OR
National Provider Identifier
1588075568
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
13-09-01 Issued in OR
Practice address
2586 12TH PL SE
Salem, OR 97302
Phone
(503) 371-4160
Fax
(503) 375-9727
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13-09-01 OR Primary

Addresses

Primary practice location

2586 12TH PL SE
Salem, OR 97302

Mailing address

14600 NW Cornell Rd
Portland, OR 97229-5442
Phone (503) 597-9023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Creekside Counseling Inc Addiction (Substance Use Disorder) Past Accepting new patients
Creekside Counseling, Inc Past Accepting new patients

Organizations & group practices 2

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1588075568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295442",
            "telephone_number": "503-597-9023",
            "fax_number": "503-375-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2586 12TH PL SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-371-4160",
            "fax_number": "503-375-9727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEER",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "13-09-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.