Active NPI
Jessica Marie Spencer, LPC, CADCII
- Mental Health Counselor
- Bend, OR
National Provider Identifier
1902003387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C5759
- Practice address
- 2965 NE Conners Ave
Bend, OR 97701-7753 - Phone
- (412) 253-8695
- NPI assigned
- Jun 29, 2007
- Sex
- Female
- Sole proprietor
- No
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 | C5759 | OR | Primary |
Addresses
Primary practice location
2965 NE Conners Ave
Bend, OR 97701-7753
Mailing address
938 NE Steins Pillar Dr
Prineville, OR 97754-1668
Phone (971) 409-0720
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 |
|---|---|---|---|
| C5759 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1902003387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "938 NE STEINS PILLAR DR",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977541668",
"telephone_number": "971-409-0720",
"fax_number": "360-397-8248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2965 NE CONNERS AVE",
"city": "BEND",
"state": "OR",
"postal_code": "977017753",
"telephone_number": "412-253-8695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPENCER",
"first_name": "JESSICA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPC, CADCII",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-29",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C5759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.