Active NPI
Heidi Jolson, MA LPC NCC CADC I
- Professional Counselor
- Portland, OR
National Provider Identifier
1417917246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C1694
- Practice address
- 4300 NE Fremont St Ste 260
Portland, OR 97213-1100 - Phone
- (503) 709-0456
- Fax
- (503) 334-1529
- NPI assigned
- Mar 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 990318 | OR | |
| Professional Counselor | 101YP2500X | C1694 | OR | Primary |
Addresses
Primary practice location
4300 NE Fremont St Ste 260
Portland, OR 97213-1100
Mailing address
4300 NE Fremont St Ste 260
Portland, OR 97213-1100
Phone (503) 709-0456
Other names 1
- Heidi N Jacobson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | heidijolson@hushmail.com | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 990318 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| C1694 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651795200000",
"number": "1417917246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 NE FREMONT ST STE 260",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131100",
"telephone_number": "503-709-0456",
"fax_number": "503-334-1529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 NE FREMONT ST STE 260",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972131100",
"telephone_number": "503-709-0456",
"fax_number": "503-334-1529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLSON",
"first_name": "HEIDI",
"name_prefix": "Ms.",
"credential": "MA LPC NCC CADC I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-24",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "990318",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C1694",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "heidijolson@hushmail.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "general info",
"address_1": "4300 NE Fremont St Ste 260",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972131100",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "HEIDI",
"last_name": "JACOBSON",
"middle_name": "N",
"credential": "MA CADC I",
"code": "1",
"type": "Former Name"
}
]
}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 May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.