Jennifer Reavis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

182 SW Academy St Ste 333
Dallas, OR 97338-1996

Phone

(503) 623-9289

NPI assigned

Aug 9, 2016

Last updated

Jan 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1851845630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 CITY VIEW ST STE B",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023325",
            "telephone_number": "541-344-1121",
            "fax_number": "541-344-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SW ACADEMY ST STE 333",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381996",
            "telephone_number": "503-623-9289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1195 City View St Ste B",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974023325",
            "country_code": "US",
            "telephone_number": "541-344-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Dallas, OR
• Providers in Dallas, 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 24, 2020; 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.