Active NPI
Holly Kay Severson, LPC
- Mental Health Counselor
- Hillsboro, OR
National Provider Identifier
1376652057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C1272
- Practice address
- 535 SE Washington St
Hillsboro, OR 97123-4142 - Phone
- (503) 913-0425
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C1272 | OR | Primary |
Addresses
Primary practice location
535 SE Washington St
Hillsboro, OR 97123-4142
Mailing address
12584 NW Lilywood Dr
Portland, OR 97229-8515
Phone (503) 913-0425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1272 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376652057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12584 NW LILYWOOD DR",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972298515",
"telephone_number": "503-913-0425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 SE WASHINGTON ST",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971234142",
"telephone_number": "503-913-0425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERSON",
"first_name": "HOLLY",
"middle_name": "KAY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C1272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.