KYLIE GOSS-DEDRICKSON
NPI 1740748409
Counselor in Portland, OR

Q: What is Kylie Goss-dedrickson's NPI number?

The NPI number for Kylie Goss-dedrickson is 1740748409. It was assigned to this individual provider in the NPPES registry on March 12, 2019.

Q: What is Kylie Goss-dedrickson's specialty?

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

Q: Is Kylie Goss-dedrickson enrolled in Medicare?

No. Kylie Goss-dedrickson has opted out of Medicare through September 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since March 12, 2019Opted out of Medicare · through Sep 2, 2027

3415 SE POWELL BLVD, PORTLAND, OR 97202(503) 234-9591 Get Directions Write a Review

NPPES record last updated: March 12, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kylie Goss-dedrickson NPPES

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

KYLIE GOSS-DEDRICKSON (NPI 1740748409) is an individual counselor in Portland, Oregon and active in the NPI registry since March 2019. She has opted out of Medicare through September 2, 2027.

NPPES Registry Identity

NPI1740748409

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameKYLIE GOSS-DEDRICKSON

Location Address3415 SE POWELL BLVDPortland, OR 97202-3371

Mailing Address3415 Se Powell BlvdPortland, OR 97202-3371

Phone(503) 234-9591

Sole ProprietorNo

Enumeration DateMarch 12, 2019

✔ NPI 1740748409 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.

3415 SE POWELL BLVD, Portland, OR 97202

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.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

Kylie Goss-dedrickson 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 September 2, 2025 through September 2, 2027.

Opt-Out Effective DateSeptember 2, 2025

Opt-Out In Effect ThroughSeptember 2, 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.

AMY HETLAGE MSW

Social Worker