DR. AMELIA J WILCOX PH.D.
NPI 1164933537
Psychologist - Clinical in Portland, OR

Active since October 12, 2017Opted out of Medicare · through Jan 1, 2027
3434 SW KELLY AVE, PORTLAND, OR 97239(503) 490-5793 Get Directions Write a Review

NPPES record last updated: October 12, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Amelia J Wilcox Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AMELIA J WILCOX PH.D. (NPI 1164933537) is an individual clinical provider in Portland, Oregon, licensed in Oregon (2636) and active in the NPI registry since October 2017. She has opted out of Medicare through January 1, 2027.

NPPES Registry Identity

NPI1164933537
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. AMELIA J WILCOXCredential: PH.D.
Location Address3434 SW KELLY AVEPortland, OR 97239-4630
Mailing Address3434 Sw Kelly AvePortland, OR 97239-4630 · (503) 490-5793
Sole ProprietorYes
Enumeration DateOctober 12, 2017
NPI 1164933537 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in OR · 2636
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

3434 SW KELLY AVE, Portland, OR 97239

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Amelia J Wilcox Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2017 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2017
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
3434 SW KELLY AVE
PORTLAND, OR 97239
Counselor (Mental Health)
3434 SW KELLY AVE
PORTLAND, OR 97239
Psychologist (Clinical)
3434 SW KELLY AVE
PORTLAND, OR 97239
Marriage & Family Therapist
3434 SW KELLY AVE
PORTLAND, OR 97239
Counselor (Professional)
3434 SW KELLY AVE
PORTLAND, OR 97239
Nurse Practitioner (Psychiatric/Mental Health)
3434 SW KELLY AVE
PORTLAND, OR 97239

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164933537, enumerated as an "individual" on October 12, 2017.

The provider is located at 3434 SW KELLY AVE PORTLAND, OR 97239 and the phone number is (503) 490-5793.

Psychologist with taxonomy code 103TC0700X and a focus in Clinical.