Kelly Kathleen Sestero, LPC, LMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C6634 Issued in OR

Practice address

12725 SW Millikan Way Ste 300
Beaverton, OR 97005-1687

Phone

(503) 208-6511

Fax

(971) 329-4700

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 8, 2025 through Dec 8, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1457479644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12725 SW MILLIKAN WAY STE 300",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051687",
            "telephone_number": "503-208-6511",
            "fax_number": "971-329-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12725 SW MILLIKAN WAY STE 300",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970051687",
            "telephone_number": "503-208-6511",
            "fax_number": "971-329-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESTERO",
        "first_name": "KELLY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Ms.",
        "credential": "LPC, LMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-03-15",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "L00008871",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C6634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Casey Rose Sergeeff
• Karlos Sermenio
• Serve All Oregon Medical Transportation, LLP
• Lori Michelle Severson, LPC
• Emma Michelle Seynaeve, MSW
• Shad a. McLagan DC PC (Oregon Wellness Center)
• Jaxon Millice Shaffer, MA
• Kelli Shaffer, RDH

• Mental Health Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.

Verify at the official NPI Registry.