Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Nicole Petty

Individual provider Mental Health Counselor · NPI 1396480893

Jennifer Nicole Petty is a Mental Health Counselor in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2022.

Licensed in
OR
In the registry since
2022

Practice location Address checks out

621 SW Alder St Ste 520
Portland, OR 97205-3620
Phone: (503) 418-5311
Fax: (503) 494-4747
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (OR)

Record details

NPI number1396480893
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 29, 2022
Last updated in NPPESApril 29, 2022
Certification dateApril 29, 2022

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