Nicole Jennings

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

03075 Issued in KS

Practice address

420 NW 2ND St
Corvallis, OR 97330-6442

Phone

(541) 286-5487

NPI assigned

Sep 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Transformative Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Corvallis, OR
  • NPI 1972246502
  Medicare reassignment NPD

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1548744253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NW 2ND ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973306442",
            "telephone_number": "541-286-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "03075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Hunter Jeffrey, DO
• Naomi Jeffries
• Daniel Brian Jenkins, DPT
• Jennifer R. Cooper, PHD, Psychological Services, LLC
• Jennifer R. Cooper, PHD, Psychological Services, PC
• Skylar C Jennings
• Katie Jennison
• Leyna Jensen, L.AC.
• Jenwel Counseling LLC
• George Jeries, DPT

• Marriage & Family Therapist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.