Active NPI
Laurie Louise Crandall-Bass, MA
- Marriage & Family Therapist
- Portland, OR
National Provider Identifier
1316111404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 2410 SE 121St Ave
#216
Portland, OR 97216-4066 - Phone
- (503) 544-4402
- NPI assigned
- Apr 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | Primary | ||
| Mental Health Counselor | 101YM0800X |
Addresses
Primary practice location
2410 SE 121St Ave
#216
Portland, OR 97216-4066
Mailing address
3424 NE Bryce St
Portland, OR 97212
Phone (503) 544-4402
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257984000000",
"number": "1316111404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3424 NE BRYCE ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97212",
"telephone_number": "503-544-4402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 SE 121ST AVE",
"address_2": "#216",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972164066",
"telephone_number": "503-544-4402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANDALL-BASS",
"first_name": "LAURIE",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-18",
"last_updated": "2009-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.