Individual provider Active NPI

Jermecia Joy Watkins, MSW

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1053094730
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11010 SE Division St Ste 202
Portland, OR 97266-6400
Phone
(503) 335-5975
Fax
(503) 335-5974
NPI assigned
Aug 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

11010 SE Division St Ste 202
Portland, OR 97266-6400

Mailing address

11010 SE Division St Ste 202
Portland, OR 97266-6400
Phone (503) 335-5975

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL wp.options.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services of Oregon Mental Health CurrentSince Aug 13, 2023 Accepting new patients

Locations

11010 SE Division St
Ste 202
Portland, OR 97266
Phone (503) 335-5975

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1053094730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11010 SE DIVISION ST STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666400",
            "telephone_number": "503-335-5975",
            "fax_number": "503-335-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 SE DIVISION ST STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972666400",
            "telephone_number": "503-335-5975",
            "fax_number": "503-335-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "JERMECIA",
        "middle_name": "JOY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wp.options.org",
            "affiliation": "N",
            "address_1": "3500 Chad Dr Ste 350",
            "city": "Eugene",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974087602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.