Active NPI
Crystal Nichole Harrel, LCSW
- Clinical Social Worker
- Rainier, OR
National Provider Identifier
1669818522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L10511
- Practice address
- 207 W a St Unit 1671
Rainier, OR 97048-0860 - Phone
- (503) 935-7770
- Fax
- (503) 597-8968
- NPI assigned
- May 20, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1669818522 | OR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | OR | ||
| Clinical Social Worker | 1041C0700X | L10511 | OR | Primary |
Addresses
Primary practice location
207 W a St Unit 1671
Rainier, OR 97048-0860
Mailing address
207 W a St Unit 1671
Rainier, OR 97048-0860
Phone (503) 935-7770
Other practice location 1
58646 McNulty Way
Saint Helens, OR 97051-6210
Phone (503) 397-5211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 195164 | 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 |
|---|---|---|---|
| 1669818522 | OR | MD | Mental Health Counselor |
| L10511 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1669818522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 W A ST UNIT 1671",
"city": "RAINIER",
"state": "OR",
"postal_code": "970480860",
"telephone_number": "503-935-7770",
"fax_number": "503-597-8968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 W A ST UNIT 1671",
"city": "RAINIER",
"state": "OR",
"postal_code": "970480860",
"telephone_number": "503-935-7770",
"fax_number": "503-597-8968"
}
],
"practiceLocations": [
{
"address_1": "58646 McNulty Way",
"address_purpose": "LOCATION",
"city": "Saint Helens",
"state": "OR",
"postal_code": "970516210",
"country_code": "US",
"telephone_number": "503-397-5211",
"fax_number": "503-397-5373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARREL",
"first_name": "CRYSTAL",
"middle_name": "NICHOLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-20",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "1669818522",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OR",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L10511",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "195164",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rainier, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.