Active NPI
Kevin Barry McGovern, PH.D.
- Cognitive & Behavioral Psychologist
- Portland, OR
National Provider Identifier
1043439532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 278
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 278 | OR | MD | Forensic 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.