Individual provider Active NPI

Crystal Copenhaver, MSW

  • Social Worker
  • Ontario, OR
National Provider Identifier
1043615545
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
702 Sunset Dr
Ontario, OR 97914-3121
Phone
(541) 889-9167
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X Primary

Addresses

Primary practice location

702 Sunset Dr
Ontario, OR 97914-3121

Mailing address

702 Sunset Dr
Ontario, OR 97914-3121
Phone (541) 889-9167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1043615545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPENHAVER",
        "first_name": "CRYSTAL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.