Janessa Kylene Headley, QMHA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1911 Hazel Ave
Medford, OR 97501-1630

Phone

(541) 476-2373

NPI assigned

May 9, 2023

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

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1740970169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 SW G ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262544",
            "telephone_number": "541-476-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 HAZEL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011630",
            "telephone_number": "541-476-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEY",
        "first_name": "JANESSA",
        "middle_name": "KYLENE",
        "credential": "QMHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "1204639",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Hayes
• Kaleef X a Hayes
• William Brendon Haynal, MD
• Allen Lewis Hayter, PA-C
• Heather Leigh Headley, RN
• Healing Hands PT and Wellness
• Health Alliance of Southern Oregon LLC
• Healthy Living at Home - Medford LLC
• Russell Hearing
• Jerry Eugene Hearns, D.C.

• Mental Health Counselor in Medford, OR
• Providers in Medford, 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 Dec 23, 2024; 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.