Individual provider Active NPI

Teresa Dawn Kehrli, LPC

  • Professional Counselor
  • Sandy, OR
National Provider Identifier
1942555768
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3552 Issued in OR
Practice address
39065 Pioneer Blvd Ste 104
Sandy, OR 97055-8088
Phone
(971) 400-5333
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X C3552 OR
Professional Counselor 101YP2500X C3552 OR Primary

Addresses

Primary practice location

39065 Pioneer Blvd Ste 104
Sandy, OR 97055-8088

Mailing address

39065 Pioneer Blvd Ste 104
Sandy, OR 97055-8088
Phone (971) 400-5333

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
I20241121004094 OR Practitioner - Mental Health Counselor 2769917178 Practice locations: Sandy, OR

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

39065 Pioneer Blvd
Suite 104
Sandy, OR 97055-8088
Phone (971) 400-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C3552ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Perspectives Counseling PastSince Oct 4, 2024 Accepting new patients

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1942555768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39065 PIONEER BLVD STE 104",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970558088",
            "telephone_number": "971-400-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39065 PIONEER BLVD STE 104",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970558088",
            "telephone_number": "971-400-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHRLI",
        "first_name": "TERESA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "C3552",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, OR

Sources for this page

Verify at the official NPI Registry.