Active NPI
Cassie Fort, ATR, LPC
- Art Therapist
- Salem, OR
National Provider Identifier
1588165807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 12-122
- Practice address
- 4532 Poinsettia St NE
Salem, OR 97305-9500 - Phone
- (509) 595-0944
- NPI assigned
- Feb 22, 2018
- Last updated
- Feb 22, 2018
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C4698 | OR | |
| Art Therapist | 221700000X | 12-122 | OR | Primary |
Addresses
Primary practice location
4532 Poinsettia St NE
Salem, OR 97305-9500
Mailing address
4532 Poinsettia St NE
Salem, OR 97305-9500
Phone (509) 595-0944
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 |
|---|---|---|---|
| C4698 | OR | MD | Professional Counselor |
| 12-122 | OR | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1588165807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4532 POINSETTIA ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973059500",
"telephone_number": "509-595-0944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4532 POINSETTIA ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973059500",
"telephone_number": "509-595-0944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORT",
"first_name": "CASSIE",
"credential": "ATR, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C4698",
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "OR",
"license": "12-122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.