Individual provider Active NPI

Karen L. Dieter Kapphahn, LCSW

  • Mental Health Counselor
  • Susanville, CA
National Provider Identifier
1629044045
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCS 21751 Issued in CA
Practice address
130 S Roop St
Susanville, CA 96130-4338
Phone
(530) 257-6411
Fax
(530) 257-6411
NPI assigned
Feb 25, 2006
Last updated
Dec 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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 LCS 21751 CA Primary

Addresses

Primary practice location

130 S Roop St
Susanville, CA 96130-4338

Mailing address

PO Box 1164
Susanville, CA 96130
Phone (530) 249-6410

Other names 1

  • Ms. Karen L Dieter Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040310000499 CA Practitioner - Clinical Social Worker 8022906007 Reassigns benefits to 1 organization
Practice locations: Susanville, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1816 1St St
Susanville, CA 96130-4561
Phone (530) 249-6410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 21751CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of del Norte CurrentSince Nov 2, 2016 Accepting new patients

Locations

455 K St
Crescent City, CA 95531
Phone (707) 464-0860

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

NPI Registry JSON

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

{
    "created_epoch": "1140825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1629044045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1164",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "96130",
            "telephone_number": "530-249-6410",
            "fax_number": "530-252-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S ROOP ST",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961304338",
            "telephone_number": "530-257-6411",
            "fax_number": "530-257-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETER KAPPHAHN",
        "first_name": "KAREN",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-25",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCS 21751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "DIETER",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Susanville, CA

Sources for this page

Verify at the official NPI Registry.