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KRISTINA LOUISE DERKSEN PEER SUPPORT
NPI 1376932897
Peer Specialist in Bend, OR

Active since January 21, 2015
2577 NE COURTNEY DR, BEND, OR 97701(541) 322-7500(541) 322-7565 Get Directions Write a Review

NPPES record last updated: December 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 11, 2020, Mar 17, 2018, Jun 13, 2017 (3 updates tracked since 2017).

About Kristina Louise Derksen Peer Support NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRISTINA LOUISE DERKSEN PEER SUPPORT (NPI 1376932897) is an individual peer specialist in Bend, Oregon and active in the NPI registry since January 2015. She maintains a secondary practice location in Lincoln City.

NPPES Registry Identity

NPI1376932897
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKRISTINA LOUISE DERKSENCredential: PEER SUPPORT
Location Address2577 NE COURTNEY DRBend, OR 97701-7752
Mailing Address2577 Ne Courtney DrBend, OR 97701-7752 · (541) 322-7500 · Fax (541) 322-7565
Phone(541) 322-7500
Fax(541) 322-7565
Sole ProprietorNo
Enumeration DateJanuary 21, 2015
Last NPPES UpdateDecember 11, 20203 updates tracked since enumeration
NPPES CertifiedDecember 11, 2020
✔ NPI 1376932897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
2577 NE COURTNEY DR, Bend, OR 97701
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Other Names 1

Former Name (1)Kristina Louise Samara

Secondary Practice Location 1

Location 14422 NE Devils Lake Blvd Ste 2Lincoln City, OR 97367-5000 · Phone (541) 265-4196 · Fax (541) 994-1882

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOANNE WHITE
Counselor (Mental Health)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7500
MRS. MARINA ASHLEY KENT RN
Registered Nurse (Community Health)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7480
KATHLEEN ELIZABETH CHRISTENSEN
Registered Nurse (Community Health)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7400
DESCHUTES COUNTY OREGON
Clinic/Center (Public Health, State or Local)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7400
TONI BERUBE
Counselor (Professional)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7678
EMMA SUSANN ANDERSON LCSW
Social Worker (Clinical)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7500
TRENT MORRELL
Case Manager/Care Coordinator
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7500
TAYLOR ELIZABETH SEXTON
Counselor (Mental Health)
2577 NE COURTNEY DR
BEND, OR 97701
Deschutes County (541) 322-7500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kristina Derksen's NPI number?

The NPI number for Kristina Derksen is 1376932897. It was assigned to this individual provider in the NPPES registry on January 21, 2015. The provider is also known as Kristina Louise Samara.

Where is Kristina Derksen located?

Kristina Derksen practices at 2577 NE Courtney Dr, Bend, OR 97701. The listed phone number is (541) 322-7500.

What is Kristina Derksen's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kristina Derksen was last updated on December 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.