Individual provider Active NPI

Jo Vierria Pedro-Frye, LPC, MS, PMP, CADC 1

  • Mental Health Counselor
  • La Grande, OR
National Provider Identifier
1366802969
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C10044 Issued in OR
Practice address
307 Meadow CT
La Grande, OR 97850-1204
Phone
(541) 215-9106
NPI assigned
Feb 25, 2016
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18-01-26 OR
Mental Health Counselor 101YM0800X C10044 OR Primary

Addresses

Primary practice location

307 Meadow CT
La Grande, OR 97850-1204

Mailing address

307 Meadow CT
La Grande, OR 97850-1204
Phone (541) 215-9106

Other practice location 1

105 Fir St Ste 327
LA Grande, OR 97850-2663
Phone (541) 215-9106

Other practice location 2

9201 SE Foster Rd # 207
Portland, OR 97266-4644
Phone (541) 215-9106

Other practice location 3

11740 SW 68th Pkwy Ste 200
Portland, OR 97223-9058
Phone (503) 902-1115

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250620003055 OR Practitioner - Mental Health Counselor 3173035698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
C10044ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Jun 9, 2025 Accepting new patients
Kindred Counseling Incorporated PastSince Dec 3, 2023 Accepting new patients
Candace Walters and Associates Past Accepting new patients

Locations

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1366802969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 MEADOW CT",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501204",
            "telephone_number": "541-215-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 MEADOW CT",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978501204",
            "telephone_number": "541-215-9106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Fir St Ste 327",
            "address_purpose": "LOCATION",
            "city": "LA Grande",
            "state": "OR",
            "postal_code": "978502663",
            "country_code": "US",
            "telephone_number": "541-215-9106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9201 SE Foster Rd # 207",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972664644",
            "country_code": "US",
            "telephone_number": "541-215-9106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11740 SW 68th Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972239058",
            "country_code": "US",
            "telephone_number": "503-902-1115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDRO-FRYE",
        "first_name": "JO",
        "middle_name": "VIERRIA",
        "credential": "LPC, MS, PMP, CADC 1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "18-01-26",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C10044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grande, OR

Sources for this page

Verify at the official NPI Registry.