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KELSEY KOTSOVOS
NPI 1639898943
Counselor in Portland, OR

Active since August 22, 2022Opted out of Medicare · through Nov 3, 2027
1507 NE 122ND AVE, PORTLAND, OR 97230(503) 258-4555 Get Directions Write a Review

NPPES record last updated: August 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kelsey Kotsovos NPPES

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

KELSEY KOTSOVOS (NPI 1639898943) is an individual counselor in Portland, Oregon and active in the NPI registry since August 2022. She has opted out of Medicare through November 3, 2027.

NPPES Registry Identity

NPI1639898943
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameKELSEY KOTSOVOS
Location Address1507 NE 122ND AVEPortland, OR 97230-1911
Mailing Address1507 Ne 122nd AvePortland, OR 97230-1911 · (503) 258-4555
Phone(503) 258-4555
Sole ProprietorNo
Enumeration DateAugust 22, 2022
NPPES CertifiedAugust 22, 2022
✔ NPI 1639898943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
1507 NE 122ND AVE, Portland, OR 97230
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kelsey Kotsovos 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 November 3, 2025 through November 3, 2027.

Opt-Out Effective DateNovember 3, 2025
Opt-Out In Effect ThroughNovember 3, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

RYAN DICKER
Social Worker
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4555
DAYNA L SANDERS MSW
Social Worker (Clinical)
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4116
CORYNN BERNHARDT CSWA, MSW
Social Worker
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4555
MS. BARBARA ALISON PANKO QMHP
Counselor
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (971) 917-6969
AVERY D'ALESSANDRO MSW
Counselor
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4555
MS. MEGAN MITCHELL
Social Worker
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4555
LAUREN KAPLAN PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4555
DANIEL MCNICHOLAS
Counselor (Mental Health)
1507 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 258-4599

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 Kelsey Kotsovos's NPI number?

The NPI number for Kelsey Kotsovos is 1639898943. It was assigned to this individual provider in the NPPES registry on August 22, 2022.

Where is Kelsey Kotsovos located?

Kelsey Kotsovos practices at 1507 NE 122nd Ave, Portland, OR 97230. The listed phone number is (503) 258-4555.

What is Kelsey Kotsovos's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Kelsey Kotsovos enrolled in Medicare?

No. Kelsey Kotsovos has opted out of Medicare through November 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Kelsey Kotsovos accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Kelsey Kotsovos as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelsey Kotsovos was last updated on August 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.