Jennifer Miatke, MA, LPC, MDIV, CADCI

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3620 Issued in OR

Practice address

18 Portland Ave
Medford, OR 97504-7309

Phone

(541) 613-2697

Fax

(541) 245-1530

NPI assigned

Mar 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Addictions Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Medford, OR
  • NPI 1346282035
  NPD (past)

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1275926305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15097 HIGHWAY 66",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975209400",
            "telephone_number": "541-613-2697",
            "fax_number": "541-245-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PORTLAND AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047309",
            "telephone_number": "541-613-2697",
            "fax_number": "541-245-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIATKE",
        "first_name": "JENNIFER",
        "credential": "MA, LPC, MDIV, CADCI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-13",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3620",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Paisley Meyer, PMHNP-BC
• Elena Carrie Meyer, MS, LPC, NCC
• Joshua Daniel Meyer, RN
• Meyerding Surgical Associates Inc
• Eugene V Meyerding Jr., DMD
• Michael F Oconnell PHD
• Michael Rulon, M.D., L.L.C.
• Philip Fred Michael, M.D.
• Denna Margaret Michail, PSS
• Aimee K Michel

• Professional Counselor in Medford, OR
• Providers in Medford, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.