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

Jeremy John Archibald, MHINTERN

Individual provider Mental Health Counselor · NPI 1013289578

Jeremy John Archibald, MHINTERN is a Mental Health Counselor in Salem, Oregon. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
In the registry since
2012
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Practice location Address checks out

3867 Wolverine St NE Bldg F
Salem, OR 97305-4266
Phone: (503) 588-5352
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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 number1013289578
Entity typeIndividual (Type 1)
GenderMale
Credentials MHINTERN
Sole proprietorYes
NPI enumeratedJanuary 31, 2012
Last updated in NPPESJune 9, 2022
Certification dateJune 9, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated

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