MS. KERRY HEADLEY LPC
NPI 1255254017
Counselor - Mental Health in Portland, OR
About Ms. Kerry Headley Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. KERRY HEADLEY LPC (NPI 1255254017) is an individual mental health provider in Portland, Oregon, licensed in Oregon (C7855) and active in the NPI registry since July 2026. She has opted out of Medicare through April 28, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Ms. Kerry Headley Lpc 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 April 28, 2024 through April 28, 2028.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kerry Headley's NPI number?
The NPI number for Kerry Headley is 1255254017. It was assigned to this individual provider in the NPPES registry on July 30, 2026.
Where is Kerry Headley located?
Kerry Headley practices at 5802 SE Belmont St Apt 11, Portland, OR 97215. The listed phone number is (503) 512-9738.
What is Kerry Headley's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Kerry Headley enrolled in Medicare?
No. Kerry Headley has opted out of Medicare through April 28, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Kerry Headley was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ms. Kerry Headley, LPC · NPI 1255254017
Mental Health provider in Portland, Oregon. Individual provider, active in the CMS NPPES registry since July 30, 2026.
## Identity
- **NPI:** 1255254017 (Entity type: Individual)
- **Enumerated:** July 30, 2026
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** C7855 (Oregon)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 5802 SE BELMONT ST APT 11, Portland, OR 97215-1900
- **Phone:** (503) 512-9738
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through April 28, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 30, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1255254017) · Data from the CMS NPPES public registry.