Kristin Mathes Clinical Mental Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KRISTIN MATHES CLINICAL MENTAL HEALTH

Practice address

1622 NW Awbrey Rd
Bend, OR 97703-1833

Phone

(920) 286-2316

NPI assigned

Sep 12, 2024

Organization subpart

No

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

Authorized official

Name

Kristin Marie Mathes, LCSWNPI 1518472489

Title

Owner

Phone

(920) 286-2316

Specialties & licenses 1

Addresses

Other names 1

• Emerge Surf and Somatic Therapy Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristin Marie Mathes, LCSW

  • Clinical Social Worker
  • Bend, OR
  • NPI 1518472489
  NPD Authorized official

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1700612934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SW CENTURY DR",
            "address_2": "SET 100 PMB 5040",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "920-286-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 NW AWBREY RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031833",
            "telephone_number": "920-286-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN MATHES CLINICAL MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "MATHES",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-286-2316",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerge Surf and Somatic Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Krieves, MD
• Kristi Holmberg
• Kristi Jett, MD
• Tessa Kristiansen, CRM
• Kristin Brooks Pmhnp LLC
• Stephen Daniel Krivan, PA-C
• Daniel Kriz, PSY.D., ABPDN
• Morgan A Kriz, DPT
• Bryan Krogstad, LCSW
• Adrian Michael Krueger, P.A-C

• Clinical Social Worker in Bend, OR
• Providers in Bend, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.