Katie A Van Komen, CDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO60767403 Issued in WA

Practice address

1206 N Dolarway Rd Ste 114
Ellensburg, WA 98926-8392

Phone

(509) 457-5653

NPI assigned

Dec 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Barth and Associates

  • Case Management Agency
  • Yakima, WA
  • NPI 1891823217
  NPD (past)

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1922570217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E LINCOLN AVE STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012348",
            "telephone_number": "509-457-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N DOLARWAY RD STE 114",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989268392",
            "telephone_number": "509-457-5653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Lincoln Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989012348",
            "country_code": "US",
            "telephone_number": "509-457-5653",
            "fax_number": "509-457-3107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN KOMEN",
        "first_name": "KATIE",
        "middle_name": "A",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60767403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Valiant
• Valley Counseling Services, LLC
• Valley Hearing Associates LLP
• Valley Psychological Services
• Valley Vision Associates, LLP
• Jerelyn Vanmeter, L.M.F.T.
• Susan Kelly Vantuinen
• Richard D Vaughan, M.D.
• Jessica Alexis Vaughn
• Julie Verheul, LMHC

• Addiction (Substance Use Disorder) Counselor in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.