Individual provider Active NPI

Taylor Klaus-Vineyard, CADC, QMHP

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1407249063
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MC60593925 Issued in WA
Practice address
1427 SE 182ND Ave
Portland, OR 97233-5008
Phone
(503) 761-6006
Fax
(503) 761-1434
NPI assigned
Mar 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 15-07-2-1 OR
Mental Health Counselor 101YM0800X 10311 CA
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X MC60593925 WA Primary

Addresses

Primary practice location

1427 SE 182ND Ave
Portland, OR 97233-5008

Mailing address

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250303000813 CA Practitioner - Mental Health Counselor 3173044526 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15-07-2-1ORMDAddiction (Substance Use Disorder) Counselor
MC60593925WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Coda, Inc. CurrentSince Jun 3, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 4, 2025 Accepting new patients
Coda, Inc. Addiction (Substance Use Disorder) CurrentSince Jun 3, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Feb 4, 2025 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

1027 E Burnside St
Portland, OR 97214

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1407249063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-269-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 SE 182ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335008",
            "telephone_number": "503-761-6006",
            "fax_number": "503-761-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLAUS-VINEYARD",
        "first_name": "TAYLOR",
        "credential": "CADC, QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-06",
        "last_updated": "2025-05-27",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "15-07-2-1",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "10311",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60593925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.