Active NPI
Crystal M Tompte, CADCI CRM PSS QMHA-I
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1548613235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 18-05-31
- Practice address
- 17645 NW Saint Helens Rd
Portland, OR 97231-1729 - Phone
- (503) 621-1069
- Fax
- (503) 621-0200
- NPI assigned
- Jul 18, 2016
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 17-CRM-II-009 | OR | |
| Mental Health Counselor | 101YM0800X | 22-QMHA-I-003296 | OR | |
| Peer Specialist | 175T00000X | THW00002329 | OR | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18-05-31 | OR | Primary |
Addresses
Primary practice location
17645 NW Saint Helens Rd
Portland, OR 97231-1729
Mailing address
1776 SW Madison St
Portland, OR 97205-1715
Phone (503) 224-1044
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500730737 | Medicaid | OR | |
| 500744187 | Medicaid | OR | |
| 500783053 | Medicaid | OR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-CRM-II-009 | OR | MD | Addiction (Substance Use Disorder) Counselor |
| 22-QMHA-I-003296 | OR | MD | Mental Health Counselor |
| THW00002329 | OR | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1548613235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 SW MADISON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972051715",
"telephone_number": "503-224-1044",
"fax_number": "503-621-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17645 NW SAINT HELENS RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972311729",
"telephone_number": "503-621-1069",
"fax_number": "503-621-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMPTE",
"first_name": "CRYSTAL",
"middle_name": "M",
"credential": "CADCI CRM PSS QMHA-I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-18",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "17-CRM-II-009",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "22-QMHA-I-003296",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OR",
"license": "THW00002329",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "18-05-31",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500730737",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500744187",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500783053",
"state": "OR"
}
],
"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 Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.