Individual provider Active NPI

Dale Kristen McQueeney, FPMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • La Grande, OR
National Provider Identifier
1679958300
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
075088-23 Issued in NH
Practice address
1204 N Ave
La Grande, OR 97850-2464
Phone
(541) 910-9929
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 075088-23 NH Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 23-R-56 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202001101NP-PP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP151054 ME

Addresses

Primary practice location

1204 N Ave
La Grande, OR 97850-2464

Mailing address

5 Windsor PL
Poland, ME 04274-7501
Phone (207) 998-4157

Other practice location 1

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

Other practice location 2

244 High Watch Rd
Effingham, NH 03882-8336
Phone (603) 230-2488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, OR, NH3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150917002012 ME Practitioner - Nurse Practitioner 1557678976 Reassigns benefits to 1 organization
I20200709000122 OR Practitioner - Nurse Practitioner 1557678976
I20221129000785 NH Practitioner - Nurse Practitioner 1557678976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Belonging Medical Group PLLCGroup PAC ID 8022443878, 39 clinicians

Practice addresses (Care Compare)

25 Green St
Lebanon, NH 03766-1706
Phone (866) 679-0831

456 Union St
Manchester, NH 03103-5215
Phone (866) 679-0831

7 Oak Hill Ter
Suite 205
Scarborough, ME 04074-8996
Phone (866) 679-0831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23-R-56ORMDAddiction (Substance Use Disorder) Counselor
CNP151054MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Belonging Medical Group PLLC Addiction (Substance Use Disorder) CurrentSince Mar 23, 2022 Accepting new patients

Locations

7 Oak Hill Ter
Ste 205
Scarborough, ME 04074

25 Green St
Lebanon, NH 03766
Phone (802) 478-0597

456 Union St
Manchester, NH 03103

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": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1679958300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WINDSOR PL",
            "city": "POLAND",
            "state": "ME",
            "postal_code": "042747501",
            "telephone_number": "207-998-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N AVE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978502464",
            "telephone_number": "541-910-9929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Moody St",
            "address_purpose": "LOCATION",
            "city": "Saco",
            "state": "ME",
            "postal_code": "040721536",
            "country_code": "US",
            "telephone_number": "800-434-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "244 High Watch Rd",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "NH",
            "postal_code": "038828336",
            "country_code": "US",
            "telephone_number": "603-230-2488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCQUEENEY",
        "first_name": "DALE",
        "middle_name": "KRISTEN",
        "credential": "FPMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "075088-23",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "23-R-56",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202001101NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP151054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.