Individual provider Active NPI

Kathryn A Hartnett Boruff, LPC

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1033490305
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C4581 Issued in OR
Practice address
610 SW Alder St Ste 1100
Portland, OR 97205-3612
Phone
(312) 909-7152
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.007517 IL
Professional Counselor 101YP2500X C4581 OR Primary

Addresses

Primary practice location

610 SW Alder St Ste 1100
Portland, OR 97205-3612

Mailing address

7122 N Wall Ave
Portland, OR 97203-5154
Phone (312) 909-7152

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180.007517ILMDMental Health Counselor
C4581ORMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1033490305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7122 N WALL AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972035154",
            "telephone_number": "312-909-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SW ALDER ST STE 1100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053612",
            "telephone_number": "312-909-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTNETT BORUFF",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.007517",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4581",
            "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 Sep 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.