Jena Harris

Individual provider Active NPI Mental Health Counselor · Phoenix, OR

NPI 1679304208 · NPPES record last updated Aug 14, 2024

Key facts

NPI
1679304208
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
PO Box 1257
Phoenix, OR 97535-1257
Phone
(541) 535-4133
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Counseling Center, Inc. Past
since Aug 18, 2024
Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/phoenixcounseling/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

PO Box 1257
Phoenix, OR 97535-1257

Mailing address

3163 E Evans Creek Rd
Rogue River, OR 97537-5542
Phone (541) 864-0576

Other providers in Phoenix, OR

All providers in Phoenix, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.