KYLE R JOHNSON (NPI# 1922479005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922479005 |
| Entity Type | Organization |
| Organization Name | KYLE R JOHNSON |
| Other Organization Name | KLAMATH BASIN BEHAVIORAL HEALTH |
| Practice Address |
2210 N Eldorado Ave Klamath Falls OR 97601-6418 |
| Practice Telephone | 5418831030 |
| Mailing Telephone | 5418831030 |
| Mailing Fax Number | 5418842338 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2016-02-08 |
| Authorized Official Name | MR. KYLE RAYMOND JOHNSON (TREATMENT SPECIALIST) |
| Authorized Official Telephone | 5418831030 |
| Authorized Official Credential | B.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Klamath Basin Behavioral Health | Doing Business As Name - Organization |
| Street Address |
2210 N ELDORADO AVE |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97601-6418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902830524 | Klamath Child and Family Treatment Center | Voluntary or Charitable | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2006-07-10 |
| 1467051524 | Anthony Victor Anghinetti | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-10-20 |
| 1013514827 | Kassie Anderson | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-10-05 |
| 1821604828 | Ryan Matthew Conrady | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-16 |
| 1730795733 | Joy June Hobbs | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-16 |
| 1821603762 | Alejandra Avalos Vasquez | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-08 |
| 1154935542 | Deanna Kay Garren | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-02 |
| 1619581006 | Meghan Rae Gorbett | Case Manager/Care Coordinator | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-09-02 |
| 1710595160 | Katrina V Hopf | Peer Specialist | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-07-21 |
| 1104434554 | Laurie Rae Cooper | Counselor | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2020-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487311 | Socorro Guadalupe Alcala- Peres | Case Manager/Care Coordinator | 2210 N El Dorado Ave, Klamath Falls, OR 97601 | 2019-09-20 |
| 1033760053 | Melissa Ann Roy | Counselor | 2210 North El Dorado, 2210 North El Dorado, Klamath Falls, OR 97601 | 2019-09-20 |
| 1134699721 | Kristin Asta Ragnarsson | Speech-Language Pathologist | Plum Ridge Care 1401 Bryant Williams, Klamath Falls, OR 97601 | 2018-11-27 |
| 1730667445 | Nancy Leota Baley | Pharmacist | Sky Lakes Outpatient Pharmacy, 2865 Daggett Street, Klamath Falls, OR 97601 | 2018-08-03 |
| 1336511260 | Patricia Blauvelt | Occupational Therapy Assistant | 1401 Bryant Williams Dr, Klamath Falls, OR 97601 | 2015-10-30 |
| 1598160814 | Christopher S. Turner | Counselor | 635 Main St., Klamath Falls, OR 97601 | 2014-10-29 |
| 1134472582 | Whole Person Care Family Practice | Family Medicine | 2301 Mountainview Blvd. Ste B, Klamath Falls, OR 97601 | 2012-10-23 |
| 1255692687 | Billy Dean Vermaas | Physical Medicine & Rehabilitation | 204 N. 10th Street, Klamath Falls, OR 97601 | 2012-06-01 |
| 1407140700 | Wendell C Heidinger Md | Family Medicine | 2301 Clairmont Drive, Klamath Falls, OR 97601 | 2011-06-03 |
| 1740573146 | Klamath Youh Department Center | Community/Behavioral Health | 2210 Eldordo Ave, Klamath Falls, OR 97601 | 2011-05-18 |
| Find all providers in zip 97601 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740573146 | Klamath Youh Department Center | Community/Behavioral Health | 2210 Eldordo Ave, Klamath Falls, OR 97601 | 2011-05-18 |
| 1851616585 | Full Circle Healing | Community/Behavioral Health | 905 Main St Ste 211, Klamath Falls, OR 97601-6066 | 2010-04-06 |
| 1073750048 | Best Care Treatment Services | Community/Behavioral Health | 5160 Summers Ln, Klamath Falls, OR 97603-8248 | 2009-01-13 |
| 1962038901 | Siskiyou Counseling | Community/Behavioral Health | 325 S 5th St, Klamath Falls, OR 97601-6107 | 2020-03-22 |
| 1295218063 | Candice Phyllis Love Shidler | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2018-09-07 |
| 1003328543 | Brittania Nicole Welch | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2017-10-24 |
| 1366953226 | Stacie Lynn Fanelli | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2017-10-18 |
| 1861863409 | Klamath Child and Family Treatment Center | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2015-10-08 |
| 1578991709 | Klamath Youth Development Center | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601 | 2013-10-25 |
| 1639515018 | Klamath Youth Development Center | Community/Behavioral Health | 2210 N Eldorado Ave, Klamath Falls, OR 97601-6418 | 2013-05-13 |
| Find all providers in KLAMATH FALLS | ||||
| City | KLAMATH FALLS |
| Zip Code | 97601 |
Please comment or provide details below to improve the information on KYLE R JOHNSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.