Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jesse Samuel Kern

Individual provider Mental Health Counselor · NPI 1467827139

Jesse Samuel Kern is a Clinical Social Worker in Portland, Oregon. Qualified in 2014, 12 years ago. Practices with Sondermind Provider Network LLC, a 1,258-clinician group and accepts Medicare assignment. Licensed in Arizona and Oregon.

Years since qualifying
12
Licensed in
AZ, OR
In the registry since
2015
Specialties on file
3
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Practice location Address checks out

10373 NE Hancock St Ste 200
Portland, OR 97220-3873
Phone: (503) 261-6136
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L12977 (OR)
Mental Health Counselor Taxonomy 101YM0800X
Clinical Social Worker Taxonomy 1041C0700X · Licence LCSW-18630 (AZ)

Record details

NPI number1467827139
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 7, 2015
Last updated in NPPESDecember 28, 2021
Certification dateDecember 28, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Sondermind Provider Network Llc — 1258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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