Kyira Wackett, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C5188 Issued in OR

Practice address

2115 SE Adams St Ste B
Milwaukie, OR 97222

Phone

(503) 659-3480

NPI assigned

Aug 2, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Barbara Majors LLC

  • Adult Mental Health Clinic/Center
  • Milwaukie, OR
  • NPI 1104323245
  NPD (past)

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1366966012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8027 SE 49TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972060824",
            "telephone_number": "414-217-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 SE ADAMS ST STE B",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "503-659-3480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6402 Odana Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537191123",
            "country_code": "US",
            "telephone_number": "608-205-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACKETT",
        "first_name": "KYIRA",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vitality Massage Clinic
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• Kelly L Von Bargen, PTA, LMT
• Somchanh Vongsoury
• Colter Voss, MD
• Sue A Wagner, MA CCC SLP
• Helane Wahbeh
• Ellen Elssner Walberg, OCCUPATIONAL THERAPI
• Brittni Walch
• Stephen Anthony Walcott Jr.

• Professional Counselor in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.