Individual provider Active NPI

Jennelle Rhae Bartholomew, QMHP-C

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1548836216
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
26-QMHPC-001774 Issued in OR
Practice address
12360 E Burnside St
Portland, OR 97233-1042
Phone
(971) 279-4800
Fax
(971) 279-2051
NPI assigned
Jun 2, 2021
Last updated
Jan 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 26-QMHPC-001774 OR Primary

Addresses

Primary practice location

12360 E Burnside St
Portland, OR 97233-1042

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044

Other identifiers 1

IdentifierTypeStateIssuer
500793696MedicaidOR

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

LicenseStateTypeSpecialty
26-QMHPC-001774ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1548836216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331042",
            "telephone_number": "971-279-4800",
            "fax_number": "971-279-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "JENNELLE",
        "middle_name": "RHAE",
        "name_prefix": "Ms.",
        "credential": "QMHP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "26-QMHPC-001774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500793696",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 26, 2026; 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.