Individual provider Active NPI

Xylem Nilsen, LCSW, QMHP

  • Mental Health Counselor
  • Beaverton, OR
National Provider Identifier
1447655105
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
L11474 Issued in OR
Practice address
10700 SW Beaverton Hillsdale Hwy Ste 560
Beaverton, OR 97005-4791
Phone
(971) 431-8968
Fax
(971) 351-6979
NPI assigned
Oct 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X L11474 OR Primary

Addresses

Primary practice location

10700 SW Beaverton Hillsdale Hwy Ste 560
Beaverton, OR 97005-4791

Mailing address

1336 NW Flanders St
PMB 215
Portland, OR 97209
Phone (971) 431-8968

Other names 1

  • Kari Anne Nilsen Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251202003341 OR Practitioner - Clinical Social Worker 9133612716 Practice locations: Beaverton, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10700 SW Beaverton Hillsdale Hwy
Suite 560
Beaverton, OR 97005-4791
Phone (503) 230-7007

1336 NW Flanders St
Portland, OR 97209-2645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L11474ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health PastSince Nov 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1447655105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 NW FLANDERS ST",
            "address_2": "PMB 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97209",
            "telephone_number": "971-431-8968",
            "fax_number": "971-351-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SW BEAVERTON HILLSDALE HWY STE 560",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054791",
            "telephone_number": "971-431-8968",
            "fax_number": "971-351-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSEN",
        "first_name": "XYLEM",
        "credential": "LCSW, QMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-23",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L11474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARI",
            "last_name": "NILSEN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.