Mykah Conant Norville, DNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10003518 Issued in OR

Practice address

9755 SW Barnes Rd Ste 280
Portland, OR 97225-6609

Phone

(971) 429-6244

Fax

(971) 244-8593

NPI assigned

Mar 2, 2020

Last updated

Mar 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Sports Psychiatry Center LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1033933049
  NPD

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1558995217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9755 SW BARNES RD STE 280",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256609",
            "telephone_number": "971-429-6244",
            "fax_number": "971-244-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9755 SW BARNES RD STE 280",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256609",
            "telephone_number": "971-429-6244",
            "fax_number": "971-244-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORVILLE",
        "first_name": "MYKAH",
        "middle_name": "CONANT",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-02",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61364034",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10003518",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "OR",
            "license": "201242529RN",
            "primary": false
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "WA",
            "license": "RN60312665",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Paine Norton, PH.D
• Theadore Lee Norton, PA
• Timothy Norton
• Walter E Norton, M.D.
• Heather Norvelle-Minamoto, PHARMD
• Sierra Norwest, CHW
• Dave Norwood, MSW, LCSW
• Kayla Norwood, LMT
• Monique Nichol Norwood, RN
• Susan A Nosacka, OTR/L, CHT

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.