Kimberly Frazier, MS, LPC, CGACII

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C5193 Issued in OR

Practice address

12350 SE Sunnyside Rd
Clackamas, OR 97015-9320

Phone

(503) 303-4000

NPI assigned

May 31, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Haak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1902190614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12350 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159320",
            "telephone_number": "503-303-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4212 SE Division St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972061680",
            "country_code": "US",
            "telephone_number": "503-238-0705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "KIMBERLY",
        "credential": "MS, LPC, CGACII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-31",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HAAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Ann Frank, OT
• Trixy Franke, MD
• Anne Lynn Fraver, RRT
• Charles F Fraver, RRCP
• Michelle Fray, NP
• Fred Meyer Stores Inc
• Elizabeth Ann Frederick-Ragsdale, MD
• Colleen Freeman, LCSW
• Perry Freeman, RN
• Anita S French

• Professional Counselor in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.