Active NPI
Jay Lawrence Rushall, LMHC, NCC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1780298778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 714 SE 35TH Ave
Portland, OR 97214-3118 - Phone
- (760) 815-7288
- NPI assigned
- Sep 7, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
714 SE 35TH Ave
Portland, OR 97214-3118
Mailing address
714 SE 35TH Ave
Portland, OR 97214-3118
Phone (760) 815-7288
Other names 1
- Jack Rushall
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ihas@comcast.net | Direct |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Mental Health LLC | Mental Health | Past | Accepting new patients |
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.
-
- Mental Health Counselor
- Lynnwood, WA
- NPI 1255987368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701820800000",
"number": "1780298778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 SE 35TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143118",
"telephone_number": "760-815-7288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 SE 35TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143118",
"telephone_number": "760-815-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSHALL",
"first_name": "JAY",
"middle_name": "LAWRENCE",
"name_prefix": "Mr.",
"credential": "LMHC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-07",
"last_updated": "2023-12-06",
"certification_date": "2023-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ihas@comcast.net",
"affiliation": "N",
"endpointDescription": "Main Office",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5108 196th St SW Ste 310",
"city": "Lynnwood",
"state": "WA",
"country_code": "US",
"postal_code": "980366152",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JACK",
"last_name": "RUSHALL",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.