MRS. JESSICA MICHELLE SIMONETTI (NPI# 1508466574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508466574 |
| Entity Type | Individual |
| Full Name | MRS. JESSICA MICHELLE SIMONETTI |
| Credential | PH.D. |
| Practice Address |
Portland Psychotherapy Clinic, Research and Training Ce 3700 N Williams Ave Portland OR 97227 |
| Practice Telephone | 5032814852 |
| Practice Fax Number | 5035753711 |
| Mailing Telephone | 5032814852 |
| Mailing Fax Number | 5035753711 |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 3254 | OR | Behavioral Health & Social Service Providers |
| Street Address |
PORTLAND PSYCHOTHERAPY CLINIC, RESEARCH AND TRAINING CE 3700 N WILLIAMS AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| 1891101671 | Shushaun Badalian | Nurse Practitioner | 406 North Beech Street, Portland, OR 97227 | 2014-07-01 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477112480 | Stella Beatriz Kerl-mcclain | Psychologist | 2826 Sw Ridge Dr, Portland, OR 97219-6205 | 2019-06-12 |
| 1184281438 | Nicholas Alexander Schollars | Psychologist | 3050 Se Division St # 215, Portland, OR 97202-1451 | 2019-05-22 |
| 1639637432 | Bayside Psychology and Consulting, LLC | Psychologist | 1 Union St Ste 402, Portland, ME 04101-4048 | 2019-03-11 |
| 1942766985 | Alexandra R. Lash | Psychologist | 386 Fore St, Portland, ME 04101-4047 | 2019-02-14 |
| 1811416068 | Matthew Lundeberg | Psychologist | 10300 Sw Greenburg Rd Ste 271, Portland, OR 97223-5415 | 2017-09-19 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1093241838 | Dr Patricia Clark | Psychologist | 1132 Sw 19th Ave, Portland, OR 97205-1740 | 2017-05-11 |
| 1639527575 | Randall David Wright | Psychologist | 1827 Ne 44th Ave Ste 320, Portland, OR 97213-1443 | 2016-06-01 |
| 1306234489 | Charles David Maxey | Psychologist | 7145 Sw Varns St Ste 105, Portland, OR 97223-8170 | 2014-12-25 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.