Active NPI
Robin Kellett, M.ED.,CAGS,LPC,LMHC
- Professional Counselor
- Portland, OR
National Provider Identifier
1003975202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C3166
- Practice address
- 4531 SE Belmont St Ste 204
Portland, OR 97215-1675 - Phone
- (978) 394-0880
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LMHC6588 | MA | |
| Mental Health Counselor | 101YM0800X | LH60582281 | WA | |
| Professional Counselor | 101YP2500X | C3166 | OR | Primary |
Addresses
Primary practice location
4531 SE Belmont St Ste 204
Portland, OR 97215-1675
Mailing address
4531 SE Belmont St Ste 204
Portland, OR 97215-1675
Phone (978) 394-0880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMHC6588 | MA | MD | Mental Health Counselor |
| LH60582281 | WA | MD | Mental Health Counselor |
| C3166 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733443200000",
"number": "1003975202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4531 SE BELMONT ST STE 204",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972151675",
"telephone_number": "978-394-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4531 SE BELMONT ST STE 204",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972151675",
"telephone_number": "978-394-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLETT",
"first_name": "ROBIN",
"name_prefix": "Ms.",
"credential": "M.ED.,CAGS,LPC,LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "LMHC6588",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH60582281",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C3166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.