Patrice Deidre Carrello, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1626 Issued in OR

Practice address

2100 NE Broadway St Ste 323
Portland, OR 97232-1570

Phone

(541) 500-8655

NPI assigned

Dec 29, 2006

Last updated

Jul 28, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Rogue Psych Consultants, LLC

  • Mental Health Counselor
  • Ashland, OR
  • NPI 1447727110
  Medicare reassignment NPD
• Psychmed LLC

  • Clinical Psychologist
  • Portland, OR
  • NPI 1477862142
  NPD (past) Authorized official

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1437215712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2354 SE 59TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972154018",
            "telephone_number": "541-500-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NE BROADWAY ST STE 323",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321570",
            "telephone_number": "541-500-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRELLO",
        "first_name": "PATRICE",
        "middle_name": "DEIDRE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samara Carranza, MASTERS OF SCIENCE
• Leslie Carrasco
• Timothy Scott Carrasco, PA
• Sharleen Paynich Carraway, APRN, BC
• Leila Carre-Smith, CNM
• Carreon Health LLC
• Miguel D Carreon, DNP, FNP-C, AAHIVS
• Marilou N Carrera, RN
• Carmen Eugenia Carreras, MSW
• Emily A Carrico, MD

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.