Jessica Jeanne Eastlick, MA, CMHC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

R5085 Issued in OR

Practice address

5051 Main Street
Springfield, OR 97477-6934

Phone

(541) 357-4603

Fax

(541) 995-5013

NPI assigned

Oct 28, 2014

Last updated

Apr 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Jessica Jeanne Shafer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 7, 2025 through May 7, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Country Counseling

  • Psychologist
  • Harrisburg, OR
  • NPI 1598733230
  NPD
• Exodus Recovery Services LLC.

  dba Exodus Behavioral Health Services

  • Addiction (Substance Use Disorder) Counselor
  • Harrisburg, OR
  • NPI 1669092201
  NPD

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1982009320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 133",
            "city": "VENETA",
            "state": "OR",
            "postal_code": "974870133",
            "telephone_number": "541-627-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5051 MAIN STREET",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974776934",
            "telephone_number": "541-357-4603",
            "fax_number": "541-995-5013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 133",
            "address_purpose": "LOCATION",
            "city": "Veneta",
            "state": "OR",
            "postal_code": "974870133",
            "country_code": "US",
            "telephone_number": "541-627-8172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EASTLICK",
        "first_name": "JESSICA",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "MA, CMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-28",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R5085",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "R5085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500796326",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "SHAFER",
            "middle_name": "JEANNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vivian Enyo Dzata, NP
• Leita M Dzubay, M. D.
• East to West Therapy LLC
• Patrick Easter, DMD
• Ryan Easter, RN
• Rebecca Eastwood, RPH
• Anthony James Eberle, RPH
• Pam Ebert, O.D.
• Royal Eddings, LMT
• Eden Home Health of Willamette Valley, LLC (Eden Home Health)

• Professional Counselor in Springfield, OR
• Providers in Springfield, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.