Jenna Leann Li, LPC, CADC I

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C4589 Issued in OR

Practice address

2651 Commercial St SE Ste 1
Salem, OR 97302-4872

Phone

(503) 587-9937

Fax

(503) 994-8049

NPI assigned

Mar 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jenna Leann Krueger Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Counselor

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD
• Lilac Wellness

  • Multi-Specialty Clinic/Center
  • Salem, OR
  • NPI 1104322841
  NPD (past)

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

{
    "created_epoch": "1332115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1972878338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ARLENE AVE SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024939",
            "telephone_number": "541-948-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 COMMERCIAL ST SE STE 1",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024872",
            "telephone_number": "503-587-9937",
            "fax_number": "503-994-8049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Lancaster Dr NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973051221",
            "country_code": "US",
            "telephone_number": "503-361-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "JENNA",
        "middle_name": "LEANN",
        "credential": "LPC, CADC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-19",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "R3309",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "13-12-23",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2400 Lancaster Dr NE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973051221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "KRUEGER",
            "middle_name": "LEANN",
            "credential": "LPC, CADC I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert James Lewis, MA
• Steven Lionell Lewis Jr., PA-S
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• Cameron Xun Li, LAC
• Shangjian Li
• Sung Li, LMT
• Bushra Liaqat, DDS
• Liberty Dental Care PC
• Liberty Denture Clinic, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.