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JENNIFER NICOLE PETTY
NPI 1396480893
Counselor - Mental Health in Portland, OR

Active since April 29, 2022
621 SW ALDER ST STE 520, PORTLAND, OR 97205(503) 418-5311(503) 494-4747 Get Directions Write a Review

NPPES record last updated: April 29, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jennifer Nicole Petty NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER NICOLE PETTY (NPI 1396480893) is an individual mental health provider in Portland, Oregon and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1396480893
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJENNIFER NICOLE PETTY
Location Address621 SW ALDER ST STE 520Portland, OR 97205-3620
Mailing Address621 Sw Alder St Ste 520Portland, OR 97205-3620 · (503) 418-5311 · Fax (503) 494-4747
Phone(503) 418-5311
Fax(503) 494-4747
Sole ProprietorNo
Enumeration DateApril 29, 2022
NPPES CertifiedApril 29, 2022
✔ NPI 1396480893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
621 SW ALDER ST STE 520, Portland, OR 97205
Open in Google Maps ↗

Other Identifiers 1

Medicaid101YM0800XOR

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE M. LEWIS MSW
Counselor (Mental Health)
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 494-4745
DR. MARCUS EUGENE SHARPE PSY.D.
Psychologist (Clinical)
621 SW ALDER ST STE 520, AVEL GORDLY CENTER FOR HEALING (OHSU)
PORTLAND, OR 97205
Multnomah County (503) 494-4745
NAMON FRANKLIN
Counselor (Mental Health)
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 418-5311
MISS LAUREL GAIL MANSOOR LCSW, CADC1
Social Worker (Clinical)
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 494-4745
MR. ALLAN ROYCE JONES JR. LPC
Clinic/Center (Mental Health (Including Community Mental Health Center))
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 494-4745
VYSHIKA M WILLIS LMFT
Marriage & Family Therapist
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 418-5311
MAYA FERDSCHNEIDER
Counselor (Mental Health)
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 418-5311
RASHEED HASSAN SHABAZZ
Student in an Organized Health Care Education/Training Program
621 SW ALDER ST STE 520
PORTLAND, OR 97205
Multnomah County (503) 494-4745

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Petty's NPI number?

The NPI number for Jennifer Petty is 1396480893. It was assigned to this individual provider in the NPPES registry on April 29, 2022.

Where is Jennifer Petty located?

Jennifer Petty practices at 621 SW Alder St Ste 520, Portland, OR 97205. The listed phone number is (503) 418-5311.

What is Jennifer Petty's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Jennifer Petty was last updated on April 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.