NPIMap

Organization Active NPI

Licensed Psychology Associates LLC

  • Marriage & Family Therapist
  • Clackamas, OR
National Provider Identifier
1376083261
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1048 Issued in OR
Legal business name
LICENSED PSYCHOLOGY ASSOCIATES LLC
Practice address
9123 SE Saint Helens St Ste 270B
Clackamas, OR 97015-6801
Phone
(855) 583-2842
Fax
(503) 678-9751
NPI assigned
Feb 27, 2017
Last updated
Feb 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Authorized official

Name
Dr. Judatha Temple Kline, MA, MA, PHD, LMFTNPI 1184749442
Title
Member, LLC
Phone
(855) 583-2842

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T1048 OR Primary

Addresses

Primary practice location

9123 SE Saint Helens St Ste 270B
Clackamas, OR 97015-6801

Mailing address

9123 SE Saint Helens St Ste 270B
Clackamas, OR 97015-6801
Phone (855) 583-2842

Other identifiers 1

IdentifierTypeStateIssuer
1184749442OtherNPPES FOR JUDATHA KLINE, PH.D. LMFT

National Provider Directory

National Provider Directory

Locations

9123 SE Saint Helens St
Ste 270B
Clackamas, OR 97015
Phone (855) 583-2842

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1376083261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9123 SE SAINT HELENS ST STE 270B",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156801",
            "telephone_number": "855-583-2842",
            "fax_number": "503-678-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 SE SAINT HELENS ST STE 270B",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156801",
            "telephone_number": "855-583-2842",
            "fax_number": "503-678-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LICENSED PSYCHOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "JUDATHA",
        "authorized_official_middle_name": "TEMPLE",
        "authorized_official_title_or_position": "MEMBER, LLC",
        "authorized_official_telephone_number": "855-583-2842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MA, MA, PHD, LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES FOR JUDATHA KLINE, PH.D. LMFT",
            "identifier": "1184749442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.