Kymberli Dawn Mills, MS, QMHP, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C8045 Issued in OR

Practice address

104 SW Kinkade Rd
Boardman, OR 97818

Phone

(541) 481-2911

Fax

(541) 481-2006

NPI assigned

Jan 4, 2017

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

• Kymberli Dawn Erevia Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Community Counseling Solutions

  • Rural Health Clinic/Center
  • John Day, OR
  • NPI 1487992665
  NPD
• Community Counseling Solutions

  • Addiction (Substance Use Disorder) Counselor
  • Heppner, OR
  • NPI 1578501771

  Mental Health

  NPD
• Grant County

  • Family Nurse Practitioner
  • John Day, OR
  • NPI 1629009022
  NPD

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1982149647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 469",
            "city": "HEPPNER",
            "state": "OR",
            "postal_code": "978360469",
            "telephone_number": "541-676-9161",
            "fax_number": "541-676-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SW KINKADE RD",
            "city": "BOARDMAN",
            "state": "OR",
            "postal_code": "97818",
            "telephone_number": "541-481-2911",
            "fax_number": "541-481-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58581 Columbia River Hwy",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970513225",
            "country_code": "US",
            "telephone_number": "971-230-0156 x316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLS",
        "first_name": "KYMBERLI",
        "middle_name": "DAWN",
        "credential": "MS, QMHP, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-04",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000002263",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C8045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYMBERLI",
            "last_name": "EREVIA",
            "middle_name": "DAWN",
            "credential": "MS, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven F Maher, M.D.
• Stevens Cloyd Marshall, D.O.
• Emily Ann May, QMHA
• Alysia Marie McDonald, PA-C
• Camren Lee Miller, PEER SUPPORT
• Lori Montez
• Saige Moore
• Cydney M. Morgan, MA, QMHP
• Janet Morgan
• Morrow County Health District

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.