Individual provider Active NPI

Kevin Christaldi, M.A.

  • Counselor
  • Milwaukie, OR
National Provider Identifier
1942735675
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
4105 SE International Way Ste 501
Milwaukie, OR 97222-8855
Phone
(503) 496-3201
NPI assigned
May 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

4105 SE International Way Ste 501
Milwaukie, OR 97222-8855

Mailing address

14600 NW Cornell Rd
Portland, OR 97229-5442

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
I20240716002744 OR Practitioner - Mental Health Counselor 6103361910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Barbara Majors LLCGroup PAC ID 6608139498, 9 clinicians

Practice addresses (Care Compare)

13110 SE Sunnyside Rd
Suite B
Clackamas, OR 97015-8468
Phone (503) 659-3480

2115 SE Adams St
Milwaukie, OR 97222-7773
Phone (503) 659-3480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Majors LLC CurrentSince Apr 19, 2024 Accepting new patients
Lifeworks NW PastSince Sep 27, 2017 Accepting new patients

Locations

13110 SE Sunnyside Rd
Ste B
Clackamas, OR 97015
Phone (503) 659-3480

2115 SE Adams St
Portland, OR 97222
Phone (503) 659-3480

Organizations & group practices 2

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1942735675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 SE INTERNATIONAL WAY STE 501",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972228855",
            "telephone_number": "503-496-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTALDI",
        "first_name": "KEVIN",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.