JENNIFER MICHELLE ROHOLT
NPI 1942613112
Counselor - Mental Health in Gladstone, OR

Q: What is Jennifer Roholt's NPI number?

The NPI number for Jennifer Roholt is 1942613112. It was assigned to this individual provider in the NPPES registry on June 5, 2014.

Q: What is Jennifer Roholt's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jennifer Roholt was last updated on January 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 05, 2014PECOS EnrolledAccepts Medicare Assignment

18911 PORTLAND AVE, GLADSTONE, OR 97027(503) 556-8471(503) 722-6810 Get Directions Write a Review

NPPES record last updated: January 15, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Jennifer Michelle Roholt NPPES

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

JENNIFER MICHELLE ROHOLT (NPI 1942613112) is an individual mental health provider in Gladstone, Oregon and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1942613112

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJENNIFER MICHELLE ROHOLT

Location Address18911 PORTLAND AVEGladstone, OR 97027-1630

Mailing Address18911 Portland AveGladstone, OR 97027-1630 · (503) 655-8471 · Fax (503) 722-6810

Phone(503) 556-8471

Fax(503) 722-6810

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJune 5, 2014

Last NPPES UpdateJanuary 15, 2019

✔ NPI 1942613112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

Also ListedMarriage & Family TherapistTaxonomy 106H00000X

18911 PORTLAND AVE, Gladstone, OR 97027

Open in Google Maps ↗

Other Identifiers 2

Other106H00000XOR · Mcft

Medicaid500691598OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Providence Health Plan, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer Michelle Roholt is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3274984216

PECOS Enrollment IDI20240104000225

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Leave this field empty

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.

GLADSTONE COMMUNITY CLINIC

Clinic/Center (Community Health)