Jonathan Chrystal, QMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3878 Beverly Ave NE
H Suite 11
Salem, OR 97305-1394

Phone

(503) 576-4600

Fax

(503) 584-4837

NPI assigned

Aug 11, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Mental Health, OR

  Medicare reassignment NPD
• Western Psychological and Counseling Services LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731

  Mental Health

  NPD

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1508242736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 NE 24TH AVE",
            "address_2": "#106",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321669",
            "telephone_number": "312-805-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3878 BEVERLY AVE NE",
            "address_2": "H SUITE 11",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051394",
            "telephone_number": "503-576-4600",
            "fax_number": "503-584-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRYSTAL",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "QMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Renae Christie
• Christina L Zampich a Professional Psych Corp
• Janice Sue Christodoulou, CADCII
• Christopher T Stevenson
• Joshua Dale Christopherson, DPT
• Daniela Seifert Chuhlantseff
• Jennifer Chun, PHD, QMHP
• Hayaun Chung
• Church at the Park
• Emily Church, PHARMD

• Mental Health Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.