Individual provider Active NPI

Kelsey Miller

  • Marriage & Family Therapist
  • Portland, OR
National Provider Identifier
1669082061
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
15 N Morris St
Portland, OR 97227-1541
Phone
(503) 445-7699
Fax
(503) 802-0199
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

15 N Morris St
Portland, OR 97227-1541

Mailing address

15 N Morris St
Portland, OR 97227-1541
Phone (503) 445-7699

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
I20240508002914 OR Practitioner - Marriage and Family Therapist 9032550074 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade AIDS Project CurrentSince Apr 1, 2024 Accepting new patients
Cascade AIDS Project CurrentSince Apr 1, 2024 Accepting new patients
Connective Therapy Collective Past Accepting new patients

Locations

520 NW Davis St
Ste 215
Portland, OR 97209
Phone (503) 223-5907

15 N Morris St
Portland, OR 97227
Phone (503) 230-9875

2236 SE Belmont St
Portland, OR 97214
Phone (503) 445-7699

Organizations & group practices 3

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1669082061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N MORRIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271541",
            "telephone_number": "503-445-7699",
            "fax_number": "503-802-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N MORRIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271541",
            "telephone_number": "503-445-7699",
            "fax_number": "503-802-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.