Ethan Pettyjohn, LPC
NPI 1619452307 · Professional Counselor · Portland, OR
Enrolled with Medicare as Practitioner - Mental Health Counselor · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ethan Pettyjohn, LPC is a Professional Counselor provider in Portland, OR (NPI 1619452307).
Provider details
- NPI number
- 1619452307
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- No
- License
- C7752 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-09-27
- Last updated
- 2023-11-13
- Certified
- 2023-11-13
Frequently asked questions
- What is Ethan Pettyjohn's NPI number?
- Ethan Pettyjohn's National Provider Identifier (NPI) is 1619452307, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ethan Pettyjohn's specialty?
- Ethan Pettyjohn is listed in the NPPES registry with a primary specialty of Professional Counselor (Behavioral Health & Social Service Providers).
- Where is Ethan Pettyjohn located?
- Ethan Pettyjohn's practice location on file with NPPES is 9755 Sw Barnes Rd, Portland, OR 97225-6651.
- What is Ethan Pettyjohn's phone number?
- The practice phone number listed in the NPPES registry for Ethan Pettyjohn is (503) 444-4862.
- Does Ethan Pettyjohn accept Medicare?
- Ethan Pettyjohn is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ethan Pettyjohn's NPI active?
- Yes — Ethan Pettyjohn's NPI (1619452307) is active in the NPPES registry as of the last update on 2023-11-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.