Jeanette Small

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R12074 Issued in OR

Practice address

2634 NW Shields Dr Unit 2
Bend, OR 97703-5189

Phone

(805) 637-8582

NPI assigned

Nov 24, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1679435002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 NW SHIELDS DR UNIT 2",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977035189",
            "telephone_number": "805-637-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 NW SHIELDS DR UNIT 2",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977035189",
            "telephone_number": "805-637-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "JEANETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "R12074",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "R12074",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R12074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Simon Slater, MD
• Sleep Better Bend LLC
• Lindsey Broida Kuehl Slinger, O.D.
• Jacob Jebediah Slosar
• Lou Massimo Smaldino, PHARM.D.
• Jacqueline Smelser, MSPT
• Kari Smerud, PA-C
• Alexa Christine Smith-Ellison, RN, CNM, WHNP
• Alexandra Caley Smith, RN, CNS
• Alexis Smith

• Mental Health Counselor in Bend, OR
• Providers in Bend, 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 Nov 24, 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.