Kelly Diane Boeve, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C4643 Issued in OR

Practice address

10700 SW Beaverton Hillsdale Hwy Ste 450
Beaverton, OR 97005-4736

Phone

(971) 238-2180

NPI assigned

Jun 25, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1548755341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2984 SW 153RD DR",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970035157",
            "telephone_number": "971-238-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 SW BEAVERTON HILLSDALE HWY STE 450",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970054736",
            "telephone_number": "971-238-2180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2984 SW 153rd Dr",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970035157",
            "country_code": "US",
            "telephone_number": "503-747-9186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12555 SW 1st St",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970050546",
            "country_code": "US",
            "telephone_number": "971-238-2180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10700 SW Beaverton Hillsdale Hwy Ste 560",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970054791",
            "country_code": "US",
            "telephone_number": "971-238-2180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "207 SW 1st St",
            "address_purpose": "LOCATION",
            "city": "Enterprise",
            "state": "OR",
            "postal_code": "978281203",
            "country_code": "US",
            "telephone_number": "541-426-4525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOEVE",
        "first_name": "KELLY",
        "middle_name": "DIANE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C4643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "C4643",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.