Kai Deva Carli, MA AT, ATR-P

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

11 NE MLK Blvd Ste 203
Portland, OR 97232-3579

Phone

(971) 350-1122

Fax

(971) 350-3401

NPI assigned

Sep 21, 2022

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

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

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• New Narrative

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tigard, OR
  • NPI 1265595664
  Medicare reassignment
• Rebel Heart Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1073146197
  NPD

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1750004057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8915 SW CENTER ST",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236307",
            "telephone_number": "503-726-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NE MLK BLVD STE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972323579",
            "telephone_number": "971-350-1122",
            "fax_number": "971-350-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLI",
        "first_name": "KAI",
        "middle_name": "DEVA",
        "credential": "MA AT, ATR-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Carl
• Marchelle Jaylee Carl
• Mekayla R Carlen, RD
• Karen M Carleton, N.D.
• Sarah Christine Carleton
• Jessica Carlin
• Deanne Hilde Carlisle, RD, MBA, LD
• James R Carlisle, MD
• Cody Carlman
• Carlos Ceballos, MD

• Mental Health Counselor in Portland, OR
• Providers in Portland, 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 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.