Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kevin R Kosik, CADC-R, QMHA-R, CHW

Individual provider Mental Health Counselor · NPI 1629820071

Kevin R Kosik, CADC-R, QMHA-R, CHW is a Mental Health Counselor in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2024
Specialties on file
4
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Practice location Address checks out

555 SE Martin Luther King Jr Blvd Ste 3057
Portland, OR 97214-2120
Phone: (503) 470-9844
Fax: (503) 715-4175
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X
Mental Health Counselor Taxonomy 101YM0800X
Mental Health Counselor Taxonomy 101YM0800X · Licence QMHA-R-5143 (OR)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence T-24-3714 (OR)

Record details

NPI number1629820071
Entity typeIndividual (Type 1)
GenderMale
Credentials CADC-R , QMHA-R , CHW
Sole proprietorYes
NPI enumeratedApril 1, 2024
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025

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