Active NPI
John Michael Jennings Jr., LMHC
- Mental Health Counselor
- Auburn, WA
National Provider Identifier
1902373012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH61176387
- Practice address
- 1000 Auburn Way S
Auburn, WA 98002-6132 - Phone
- (253) 939-2202
- NPI assigned
- Oct 26, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60882488 | WA | |
| Mental Health Counselor | 101YM0800X | LH61176387 | WA | Primary |
Addresses
Primary practice location
1000 Auburn Way S
Auburn, WA 98002-6132
Mailing address
3560 Bridgeport Way W Ste 2C
University Place, WA 98466-4446
Phone (253) 460-7248
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 |
|---|---|---|---|
| LH61176387 | WA | MD | Mental Health Counselor |
| MC60882488 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tacoma Integrative Psychiatry PLLC | 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.
-
- Psychiatric/Mental Health Nurse Practitioner
- University Place, WA
- NPI 1255117289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626393600000",
"number": "1902373012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3560 BRIDGEPORT WAY W STE 2C",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984664446",
"telephone_number": "253-460-7248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 AUBURN WAY S",
"city": "AUBURN",
"state": "WA",
"postal_code": "980026132",
"telephone_number": "253-939-2202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-26",
"last_updated": "2021-07-16",
"certification_date": "2021-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60882488",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH61176387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.