KERRY SAMUEL GOLDSTEIN M.A. NPI 1245493626

NPI Information

  • NPI: 1245493626
  • Provider Name: KERRY SAMUEL GOLDSTEIN, M.A.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 320 SW STARK ST STE 402
    PORTLAND, OR
    ZIP 97204
  • Phone: (503) 267-3607

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NPI Details

Kerry Samuel Goldstein, M.A. is a mental health counselor in Portland, OR. Kerry Samuel Goldstein, M.A. NPI is 1245493626. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

320 SW STARK ST STE 402
PORTLAND, OR
ZIP 97204-626
Phone: (503) 267-3607

The enumeration date for this NPI number is 7/7/2008 and was last updated on 8/31/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1123190MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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