| Jennifer Michelle Roholt, | |
|
18911 Portland Ave, Gladstone, OR 97027-1630 | |
| (503) 556-8471 | |
| (503) 722-6810 |
| Full Name | Jennifer Michelle Roholt |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 18911 Portland Ave, Gladstone, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942613112 | NPI | - | NPPES |
| 500691598 | Medicaid | OR | |
| 106H00000X | Other | OR | MCFT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Clackamas County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841443587 PECOS PAC ID: 9537065560 Enrollment ID: O20031210000827 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Michelle Roholt, 18911 Portland Ave, Gladstone, OR 97027-1630 Ph: (503) 655-8471 | Jennifer Michelle Roholt, 18911 Portland Ave, Gladstone, OR 97027-1630 Ph: (503) 556-8471 |
Sara Padilla, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 880 82nd Dr Bldg A, Gladstone, OR 97027 Phone: 503-902-6430 Fax: 503-659-1994 | |
Sarah Miller, PCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 880 82nd Dr, Gladstone, OR 97027 Phone: 503-659-5515 Fax: 503-659-1994 | |
Joni Casterline, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 890 82nd Dr, Gladstone, OR 97027 Phone: 503-659-5515 | |
Ms. Karen Maline Mindt Howell, LPC Counselor Medicare: Medicare Enrolled Practice Location: 250 Princeton Ave Ste 207, Gladstone, OR 97027 Phone: 503-545-7541 Fax: 503-545-7541 | |
Brian J Hanni, LPC Counselor Medicare: Medicare Enrolled Practice Location: 890 82nd Dr, Gladstone, OR 97027 Phone: 503-659-5515 | |
Ms. Barbara Collins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 880 82nd Dr, Annex A, Gladstone, OR 97027 Phone: 503-659-5515 Fax: 503-210-2475 | |
Daniel Hazen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18000 Webster Rd, Gladstone, OR 97027 Phone: 503-722-4470 |