KRISTIN MOEN (NPI# 1093175424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093175424 |
| Entity Type | Individual |
| Full Name | KRISTIN MOEN |
| Credential | B.S.,CADC L, QMHA |
| Practice Address |
182 Sw Academy St Dallas OR 97338-1996 |
| Practice Telephone | 5035070819 |
| Mailing Telephone | 5035070819 |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-08-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15-09-17 | OR | Behavioral Health & Social Service Providers |
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457790990 | Kristin Lee Moen | Counselor | 13000 63rd Ave N, Maple Grove, MN 55369-6081 | 2013-06-18 |
| 1962739904 | Kristin Moen | Social Worker | 891 Belsly Blvd, Moorhead, MN 56560-5055 | 2009-11-12 |
| Street Address |
182 SW ACADEMY ST |
| City | DALLAS |
| State | OR |
| Zip Code | 97338-1996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841308632 | Alfredo Jose Soto | Psychiatry & Neurology | 182 Sw Academy St, Suite 30, Dallas, OR 97338-1922 | 2006-08-29 |
| 1528669918 | Helen Canchola Martinez | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2020-11-03 |
| 1013525542 | Zachary Beeler | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2020-07-21 |
| 1376175398 | Theresa Ann Kollars | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2020-02-07 |
| 1346883071 | Heather Grandis | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-10-25 |
| 1154963320 | Tori A Geter | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-10-09 |
| 1801437231 | Maria Ross | Student in an Organized Health Care Education/Training Program | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-10-07 |
| 1144871096 | Kayli Peterson | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-09-23 |
| 1174170187 | Mikel-anne Devine | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-08-23 |
| 1699320440 | Kelli Diane Bennett | Counselor | 182 Sw Academy St, Dallas, OR 97338-1996 | 2019-08-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164932042 | Stephanie Marie Renfro | Massage Therapist | 289 E Ellendale Ave #601, Dallas, OR 97338 | 2017-10-05 |
| 1588185953 | Herbert Starr Woodward IIi | Dentist | 201 Se Washington St, Dallas, OR 97338 | 2017-07-06 |
| 1851708077 | David Mooso | Pharmacist | 321 Nw Kings Valley Highway, Dallas, OR 97338 | 2014-07-21 |
| 1841615556 | Leslie Lytle | Counselor | 1020 Sw Maple St., Dallas, OR 97338 | 2014-03-04 |
| 1205265493 | Chung-fan Ni | Counselor | 182 S. W. Academy St., Academy Building, Dallas, OR 97338 | 2013-11-07 |
| 1215204300 | Ron Fritz | Counselor | 239 E. Ellendale, Suite 602, Dallas, OR 97338 | 2011-11-17 |
| 1235420167 | Deborah Kennedy | Counselor | 527 Ne Fern Ave, Dallas, OR 97338 | 2011-04-26 |
| 1821229774 | Chelsea Ruhoff Lee | Physician Assistant | 1000 Se Uglow Avenue, Flaming Medical Center, Dallas, OR 97338 | 2009-07-27 |
| 1013128560 | Larry J Vuylsteke | Social Worker | 182 S.w. Academy, Dallas, OR 97338 | 2007-05-25 |
| 1093926123 | Justin W Reed | Counselor | Academy Building, 182 S.w. Academy St. Suite 304, Dallas, OR 97338 | 2007-05-24 |
| Find all providers in zip 97338 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174184485 | Rocio Ponce | Case Manager/Care Coordinator | 1314 Grigsby Ave, Dallas, TX 75204-6873 | 2019-06-26 |
| 1144885583 | Deangela Reese | Case Manager/Care Coordinator | 1414 Belleview St Apt 334, Dallas, TX 75215-2241 | 2019-05-01 |
| 1275007551 | Gina L Escamilla | Case Manager/Care Coordinator | 6128 Misty Wood Dr, Dallas, TX 75217-5605 | 2019-01-19 |
| 1447722442 | Demetra L Williams | Case Manager/Care Coordinator | 2026 Cedar Valley Ln, Dallas, TX 75232-2306 | 2019-01-02 |
| 1154809432 | Briona Patterson | Case Manager/Care Coordinator | 1111 W Mockingbird Ln Ste 1030, Dallas, TX 75247-5028 | 2018-07-30 |
| 1457845737 | Jennifer Jo Hamilton | Case Manager/Care Coordinator | 1140 Empire Central Dr Ste 260, Dallas, TX 75247-4322 | 2018-06-19 |
| 1265931695 | Phylisity M Slaughter | Case Manager/Care Coordinator | 2811 Bonnie View Rd, Dallas, TX 75216-3303 | 2018-02-12 |
| 1427563220 | Lisa Shardon | Case Manager/Care Coordinator | 8215 Westchester Dr Ste 213, Dallas, TX 75225-6116 | 2017-12-04 |
| 1700310224 | Shalonda Duncan | Case Manager/Care Coordinator | 1449 Brook Valley Pl, Dallas, TX 75232-1519 | 2017-04-12 |
| 1710418231 | Susan Hibbs | Case Manager/Care Coordinator | 9027 Guildhall Dr, Dallas, TX 75238-3533 | 2017-03-26 |
| Find all providers in DALLAS | ||||
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| 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.