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Dr. Serita Backstrand , PsyD

Psychologist β€’ Beaverton, OR

Active NPI 1265831705 Individual Practitioner Female Practitioner Accepts Medicare assignment Telehealth (some services)
Practice location in NPPES

1791 Nw 173rd Ave Ste 140
Beaverton, OR 97006

Call 5035339806 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1791 Nw 173rd Ave Ste 140

Beaverton, OR 97006

Telephone 5035339806
Fax 5033521809
Organization at the Same NPPES Address or Phone
Harden Psychological Associates, P.c. Facility NPI 1831352632

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Vancouver, WA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Western Psychological And Counseling Services Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2015

Years since graduation

11 years (graduated 2015)

CMS Doctors and Clinicians data list 2015 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

Telehealth (some services)

Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.

What this does not show: Telehealth (some services)

It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Beaverton and Oregon

23 active clinicians are listed under Psychologist with a practice address in Beaverton, OR (742 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Beaverton

21.7% of these 23 clinicians have the CMS telehealth indicator.

21.7% of these 23 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES OR 2933

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Psychologist

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES WA PY60776565

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
164936 (OR)

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Western Psychological And Counseling Services Llc

8280 Ne Mauzey Ct, Hillsboro, OR 971249092

Phone: 5034399531

Secondary Practice Locations

208 E 25th Street, Nw Family Psychology, Llc

Vancouver, WA 986633219

Phone: 3609101522

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

14 Historical Events
πŸ“
Updated Practice Location April 01, 2019

Registered at 1791 NW 173RD AVE STE 140, BEAVERTON, OR 97006 (Tel: 5035339806)

πŸ“
Updated Business Mailing Address April 01, 2019

Registered at 1791 NW 173RD AVE STE 140, BEAVERTON, OR 970065630 (Tel: 5035339806)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 01, 2019

Psychologist (license number reported to NPPES: OR 2933)

βœ…
NPI Profile Active April 12, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location April 12, 2017

Registered at 208 E 25TH STREET, NW FAMILY PSYCHOLOGY, LLC, VANCOUVER, WA 986633219 (Tel: 3609101522)

πŸ“
Updated Business Mailing Address April 12, 2017

Registered at 208 E 25TH STREET, NW FAMILY PSYCHOLOGY, LLC, VANCOUVER, WA 986633129 (Tel: 3609101522)

πŸ‘€
Provider Name / Credentials Updated April 12, 2017

Recorded as SERITA BACKSTRAND, PSY.D

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 12, 2017

Psychologist

βœ…
NPI Profile Active September 08, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 08, 2014

Registered at 12636 SE STARK ST, PLAZA 125, BUILDING J, PORTLAND, OR 972331058 (Tel: 5032534600)

πŸ“
Business Mailing Address (Initial Record) September 08, 2014

Registered at PO BOX 82819, PORTLAND, OR 972820819 (Tel: 5032335405)

πŸ‘€
Provider Name / Credentials (Initial Record) September 08, 2014

Recorded as SERITA BACKSTRAND, M.A.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2014

Counselor

🟒
Initial NPI Registration & Enumeration August 21, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1265831705
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 21, 2014
Last Update: April 01, 2019
Sole Proprietor: Yes

Mailing Address

1791 Nw 173rd Ave Ste 140

Beaverton, OR 970065630

Phone: 5035339806

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.