Kathleen Stidd, MA CMFC, MAT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C6419 Issued in OR

Practice address

11845 SW Greenburg Rd
Suite 200
Tigard, OR 97223-6464

Phone

(503) 719-3878

NPI assigned

Sep 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Sanderson and Associates, LLC

  • Psychologist
  • Tigard, OR
  • NPI 1124652821
  Medicare reassignment NPD

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1043768500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11845 SW GREENBURG RD STE 210",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236464",
            "telephone_number": "503-719-3878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11845 SW GREENBURG RD",
            "address_2": "SUITE 200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236464",
            "telephone_number": "503-719-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIDD",
        "first_name": "KATHLEEN",
        "credential": "MA CMFC, MAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C6419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci Stevens, DPT
• Cindara Stewart
• Deanna Stewart
• Peggy Anne Stewart
• Sue Ellen Stewart, PT
• Bradley Michael Stiefel, PA-C
• Genevieve Stiers
• Katherine Rebekkah Stimson, LMT
• Rebekah Stines, MSPC, LPC INTERN
• Danielle Marie Stirnaman

• Counselor in Tigard, OR
• Providers in Tigard, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.