Church at the Park

Primary specialty

Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X

Legal business name

CHURCH AT THE PARK

Practice address

1280 Center St NE
Salem, OR 97301-4113

Phone

(503) 507-4992

NPI assigned

Mar 3, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Sean E Robertson, PSYD

Title

Chief Clinical Officer

Phone

(503) 459-7685

Specialties & licenses 3

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renata Chalukian, PEER SUPPORT

  • Peer Specialist
  • Salem, OR
  • NPI 1326747452
  NPD (past)
• Steve Charles Compton I

  • Peer Specialist
  • Salem, OR
  • NPI 1497454375
  NPD (past)

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1558061028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 FRONT ST NE STE 1-103",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010779",
            "telephone_number": "503-459-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014113",
            "telephone_number": "503-507-4992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2410 Turner Rd SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973022005",
            "country_code": "US",
            "telephone_number": "971-375-7491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2640 Portland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973010125",
            "country_code": "US",
            "telephone_number": "503-979-7054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3749 Portland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973010311",
            "country_code": "US",
            "telephone_number": "503-507-2144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHURCH AT THE PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "503-459-7685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dale Christopherson, DPT
• Jonathan Chrystal, QMHP
• Daniela Seifert Chuhlantseff
• Jennifer Chun, PHD, QMHP
• Hayaun Chung
• Emily Church, PHARMD
• Patricia Church
• Alexandra Cimpan, LPC
• Shelby Spring Cinnamon
• Victor Manuel Cisneros

• Religious Nonmedical Health Care Institution in Salem, OR
• Providers in Salem, OR by specialty
• Religious Nonmedical Health Care Institution in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.