Kimberly Coppersmith, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2869 Issued in OR

Practice address

1020 SW Taylor St Ste 855
Portland, OR 97205-2570

Phone

(971) 303-9636

Fax

(971) 200-2425

NPI assigned

Sep 29, 2011

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Valued Insight Psychotherapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1467132548
  NPD Authorized official
• Chehalem Youth and Family Services

  • Mental Illness Community Based Residential Treatment Facility
  • Newberg, OR
  • NPI 1982952958
  NPD (past)

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1083998744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SW TAYLOR ST STE 855",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052570",
            "telephone_number": "971-303-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SW TAYLOR ST STE 855",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052570",
            "telephone_number": "971-303-9636",
            "fax_number": "971-200-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPERSMITH",
        "first_name": "KIMBERLY",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Copley, LCSW
• Laura Rae Copley, LMT
• Daniel Harrison Copp, MD
• Copper Valley Integrated Health LLC
• Erika Gene Copperman, DO
• Megan Coppock, CPM, LDM
• Inez Avena Coppola, L.AC.
• Peter G Coppola, P. T.
• Constance Joan Coquillette, LCSW
• Cora Forsten LLC

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.