Active NPI
Leonard Harry Kaufman, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1972717775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1861
- Practice address
- 905 SE 14TH Ave
Portland, OR 97214-2569 - Phone
- (503) 489-7247
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1861 | DC | Primary |
Addresses
Primary practice location
905 SE 14TH Ave
Portland, OR 97214-2569
Mailing address
905 SE 14TH Ave
Portland, OR 97214-2569
Phone (503) 489-7247
Other practice location 1
30000 Connecticut Ave., NW
Suite 301
Washington, DC 20008
Phone (202) 466-5537
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1861 | DC | MD | Clinical Psychologist |
| 2744 | OR | MD | Massage Therapist |
Organizations & group practices 1
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.
-
dba Portland Mental Health & Wellness
- Clinical Psychologist
- Portland, OR
- NPI 1588041388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1972717775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 SE 14TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142569",
"telephone_number": "503-489-7247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 SE 14TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142569",
"telephone_number": "503-489-7247"
}
],
"practiceLocations": [
{
"address_1": "30000 Connecticut Ave., NW",
"address_2": "Suite 301",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "20008",
"country_code": "US",
"telephone_number": "202-466-5537",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAUFMAN",
"first_name": "LEONARD",
"middle_name": "HARRY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "DC",
"license": "1861",
"primary": true
}
],
"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 Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.