Individual provider Active NPI

Kevin Barry McGovern, PH.D.

  • Cognitive & Behavioral Psychologist
  • Portland, OR
National Provider Identifier
1043439532
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
278 Issued in OR
Practice address
13831 NW Cornell Rd
Suite 103
Portland, OR 97229-5485
Phone
(503) 644-6600
Fax
(503) 643-3798
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 278 OR Primary
Clinical Psychologist 103TC0700X 278 OR
Forensic Psychologist 103TF0200X 278 OR

Addresses

Primary practice location

13831 NW Cornell Rd
Suite 103
Portland, OR 97229-5485

Mailing address

13831 NW Cornell Rd
Suite 103
Portland, OR 97229-5485
Phone (503) 644-6600

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
278ORMDForensic Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043439532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13831 NW CORNELL RD",
            "address_2": "SUITE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295485",
            "telephone_number": "503-644-6600",
            "fax_number": "503-643-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13831 NW CORNELL RD",
            "address_2": "SUITE 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295485",
            "telephone_number": "503-644-6600",
            "fax_number": "503-643-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "KEVIN",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OR",
            "license": "278",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "278",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "OR",
            "license": "278",
            "primary": false
        }
    ],
    "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 11, 2025; 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.