Jennifer Yerty

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C4948 Issued in OR

Practice address

6536 SE Duke St
Portland, OR 97206-6665

Phone

(503) 208-5536

Fax

(503) 974-0934

NPI assigned

Apr 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Breaking Ground Counseling

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1467302778
  NPD Authorized official
• Clackamas County

  • Federally Qualified Health Center (FQHC)
  • Oregon City, OR
  • NPI 1841443587
  NPD (past)
• County of Clackamas Office of County Auditor

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milwaukie, OR
  • NPI 1245269315
  NPD (past)

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756598400000",
    "number": "1629463831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6547 SE 68TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972067315",
            "telephone_number": "503-208-5536",
            "fax_number": "503-974-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 SE DUKE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066665",
            "telephone_number": "503-208-5536",
            "fax_number": "503-974-0934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "847 NE 19th Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322684",
            "country_code": "US",
            "telephone_number": "503-238-0769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "998 Library Ct",
            "address_purpose": "LOCATION",
            "city": "Oregon City",
            "state": "OR",
            "postal_code": "970454041",
            "country_code": "US",
            "telephone_number": "503-655-8401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2705 E Burnside St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141768",
            "country_code": "US",
            "telephone_number": "503-208-5536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YERTY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2025-08-31",
        "certification_date": "2025-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "19-09-13",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C4948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500709521",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jen@breakinggroundpdx.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2705 E Burnside St Ste 206",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972141768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ian Benjamin Yeoh, LMT
• Jeffrey Yeom, LMFT
• Mark S. Yerby, MD
• Larissa Yergin
• Stephen John Yermal
• Yes Medical LLC
• Yesyes Healing Garden LLC
• Dallas Ryan Yetter
• Dennis Yeung
• Mark Anderson Yeung, LCSW, MPH

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2025; 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.