Shaniqua Jeter

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R10431 Issued in OR

Practice address

5441 S Macadam Ave Ste a
Portland, OR 97239-6106

Phone

(903) 742-6528

NPI assigned

Sep 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Essential Counseling and Resources, LLC

  • Mental Health Counselor
  • Marshall, TX
  • NPI 1174361414
  NPD Authorized official

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1720814254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "903-742-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE STE A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "903-742-6528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Valley Vw",
            "address_purpose": "LOCATION",
            "city": "Marshall",
            "state": "TX",
            "postal_code": "756727493",
            "country_code": "US",
            "telephone_number": "903-742-6528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JETER",
        "first_name": "SHANIQUA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88443",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R10431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Jessie
• Brisa Salome Jessup, NP
• Stephanie Marie Humiwat Jessup
• Alexandria Nicole Jester
• Jesus Monyeal Jesus Sanchez
• Ajitkumar N Jetmalani, MD
• Asha Jetmalani
• Laura Adams Jetmalani, PNP
• Alexandra Maria Jett, RDH
• Brandon Jett, CADC-II, QMHA-I

• 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 Jan 3, 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.