NPIMap

Individual provider Active NPI

Crystal Macias, QMHA-R, PHN

  • Addiction (Substance Use Disorder) Counselor
  • Bend, OR
National Provider Identifier
1669242129
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
T-24-3590 Issued in OR
Practice address
63158 Deschutes Market Rd
337
Bend, OR 97701-2973
Phone
(458) 600-8552
NPI assigned
Jan 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-24-3590 OR Primary
Mental Health Counselor 101YM0800X 23-QMHA-R-3759 OR
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

63158 Deschutes Market Rd
337
Bend, OR 97701-2973

Mailing address

63158 Deschutes Market Rd
337
Bend, OR 97701-2973
Phone (458) 600-8552

Other names 1

  • Crystal Ehrich Former name

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

LicenseStateTypeSpecialty
T-24-3590ORMDAddiction (Substance Use Disorder) Counselor
23-QMHA-R-3759ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
J Bar J Youth Services PastSince Jan 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1669242129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63158 DESCHUTES MARKET RD",
            "address_2": "337",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012973",
            "telephone_number": "458-600-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63158 DESCHUTES MARKET RD",
            "address_2": "337",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977012973",
            "telephone_number": "458-600-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIAS",
        "first_name": "CRYSTAL",
        "credential": "QMHA-R, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-24-3590",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHA-R-3759",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "EHRICH",
            "credential": "QMHA-R, CADC-R, PHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.