Individual provider Active NPI

Folajaiye Mukhtar Kareem, QMHP

  • Counseling Psychologist
  • Klamath Falls, OR
National Provider Identifier
1730862806
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
714 Main St Ste 200
Klamath Falls, OR 97601-6010
Phone
(541) 880-4921
Fax
(541) 288-9660
NPI assigned
Aug 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

714 Main St Ste 200
Klamath Falls, OR 97601-6010

Mailing address

714 Main St Ste 200
Klamath Falls, OR 97601-6010
Phone (541) 880-4921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20260515002599 OR Practitioner - Mental Health Counselor 5092284315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sky Lakes Medical Center IncGroup PAC ID 1052204096, 196 clinicians

Practice addresses (Care Compare)

2821 Daggett Ave
Suite 200
Klamath Falls, OR 97601-1130
Phone (541) 274-8400

Hospital & facility affiliations

  • Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grace William Health Systems CurrentSince Aug 13, 2023 Accepting new patients
Sky Lakes Medical Center Inc Past Accepting new patients

Locations

714 Main St
Ste 200
Klamath Falls, OR 97601
Phone (443) 865-6593

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1730862806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 MAIN ST STE 200",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016010",
            "telephone_number": "541-880-4921",
            "fax_number": "541-288-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 MAIN ST STE 200",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976016010",
            "telephone_number": "541-880-4921",
            "fax_number": "541-288-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAREEM",
        "first_name": "FOLAJAIYE",
        "middle_name": "MUKHTAR",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.