Active NPI
Alyssa Rose Crenshaw, LPC
- Professional Counselor
- Portland, OR
National Provider Identifier
1689076143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C3877
- Practice address
- 1715 SE 32ND Place
Portland, OR 97214 - Phone
- (503) 234-9591
- Fax
- (503) 697-6932
- NPI assigned
- Sep 16, 2014
- Last updated
- Nov 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C3877 | OR | Primary |
Addresses
Primary practice location
1715 SE 32ND Place
Portland, OR 97214
Mailing address
3415 SE Pwell Blvd.
Portland, OR 97202
Phone (503) 234-9591
Other names 1
- Alyssa Rose
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 |
|---|---|---|---|
| C3877 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1689076143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 SE PWELL BLVD.",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97202",
"telephone_number": "503-234-9591",
"fax_number": "503-697-6932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 SE 32ND PLACE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97214",
"telephone_number": "503-234-9591",
"fax_number": "503-697-6932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE CRENSHAW",
"first_name": "ALYSSA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C3877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALYSSA",
"last_name": "ROSE",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.