Individual provider Active NPI

Caitlin Keller Khoury, PHD, BCBA

  • Psychologist
  • Portland, OR
National Provider Identifier
1821472242
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2831 Issued in OR
Practice address
9555 SW Barnes Rd Ste 301
Portland, OR 97225-6670
Phone
(503) 535-6300
NPI assigned
Jul 15, 2015
Last updated
Apr 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10578 NE
Psychologist 103T00000X 2831 OR Primary
Behavior Analyst 103K00000X OR

Addresses

Primary practice location

9555 SW Barnes Rd Ste 301
Portland, OR 97225-6670

Mailing address

9555 SW Barnes Rd Ste 301
Portland, OR 97225-6670
Phone (503) 535-6300

Other practice location 1

19260 SW 65th Ave Ste 340
Tualatin, OR 97062-5710
Phone (503) 535-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10578NEMDMental Health Counselor
2831ORMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1821472242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256670",
            "telephone_number": "503-535-6300",
            "fax_number": "503-297-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256670",
            "telephone_number": "503-535-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19260 SW 65th Ave Ste 340",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970625710",
            "country_code": "US",
            "telephone_number": "503-535-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "CAITLIN",
        "middle_name": "KELLER",
        "credential": "PHD, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "10578",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2831",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.