Lamaya T Jarrell, PSS/QMHA-R

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000106422 Issued in OR

Practice address

1310 SW 17TH Ave
Portland, OR 97201-2522

Phone

(503) 231-2641

Fax

(503) 467-4077

NPI assigned

Jan 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1386340438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "503-621-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SW 17TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972012522",
            "telephone_number": "503-231-2641",
            "fax_number": "503-467-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARRELL",
        "first_name": "LAMAYA",
        "middle_name": "T",
        "credential": "PSS/QMHA-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHA-R-3567",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000106422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500815209",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Jarnagin, LMFT INTERN
• Jamie Rae Jarnot, AGACNP-BC
• Savannah Autumn Jarosz
• Cory Paul Jarrell
• Kelli Jarrell
• Randal Jarrell, PA-C
• Carol Ann Jarrett, LPN
• Sibyl B Jarrett, DMD
• Amy H. Jarvis, L.C.S.W.
• Brooke Miller Jarvis

• Peer Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.