Individual provider Active NPI

Kathryn Maitas, M.A., LPC

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1295305829
Registry record updated Sep 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C9145 Issued in OR
Practice address
670 Superior CT
Medford, OR 97504-6174
Phone
(541) 414-4931
NPI assigned
Jun 27, 2021
Last updated
Sep 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C9145 OR Primary

Addresses

Primary practice location

670 Superior CT
Medford, OR 97504-6174

Mailing address

3675 Princeton Way
Medford, OR 97504-9388
Phone (815) 382-4659

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251014002236 OR Practitioner - Mental Health Counselor 5193212108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Melissa Therapy LLCGroup PAC ID 0547783110, 2 clinicians

Practice addresses (Care Compare)

670 Superior CT
Suite 103
Medford, OR 97504-6179
Phone (541) 414-4931

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C9145ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Melissa Therapy LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

670 Superior Ct
Ste 103
Medford, OR 97504
Phone (541) 414-4931

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759017600000",
    "number": "1295305829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 PRINCETON WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049388",
            "telephone_number": "815-382-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 SUPERIOR CT",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046174",
            "telephone_number": "541-414-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITAS",
        "first_name": "KATHRYN",
        "credential": "M.A., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-27",
        "last_updated": "2025-09-28",
        "certification_date": "2025-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C9145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.