Active NPI
Jenna White
- Mental Health Counselor
- Vancouver, WA
National Provider Identifier
1811353162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CG60594950
- Practice address
- 1014 Main St
Vancouver, WA 98660-3151 - Phone
- (360) 695-1014
- Fax
- (360) 750-1374
- NPI assigned
- Dec 31, 2015
- Sex
- Female
- 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 | CG60594950 | WA | Primary |
Addresses
Primary practice location
1014 Main St
Vancouver, WA 98660-3151
Mailing address
1014 Main St
Vancouver, WA 98660-3151
Phone (360) 695-1014
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60594950 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Solutions, Inc | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/family-solutions/r4/
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.
-
- Community/Behavioral Health Agency
- Vancouver, WA
- NPI 1831258995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1811353162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1014 MAIN ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986603151",
"telephone_number": "360-695-1014",
"fax_number": "360-750-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1014 MAIN ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986603151",
"telephone_number": "360-695-1014",
"fax_number": "360-750-1374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JENNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-12-31",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CG60594950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.