Individual provider Active NPI

Jennifer Renee Mick, QMHA

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1700730447
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1520 S Peach St
Medford, OR 97501-4051
Phone
(458) 658-9386
NPI assigned
Feb 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 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 Primary

Addresses

Primary practice location

1520 S Peach St
Medford, OR 97501-4051

Mailing address

1175 E Main St Ste 2F
Medford, OR 97504-7457
Phone (458) 225-9993

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nibbus Combined Care LLC PastSince Mar 11, 2025 Accepting new patients
Nibbus Combined Care LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1771545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1700730447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E MAIN ST STE 2F",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047457",
            "telephone_number": "458-225-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S PEACH ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014051",
            "telephone_number": "458-658-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICK",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "QMHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.