Jennifer Crocker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C4884 Issued in OR

Practice address

11650 SW 67TH Ave
Tigard, OR 97223-8589

Phone

(503) 308-9465

NPI assigned

Feb 12, 2016

Last updated

Sep 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Willamette Valley Mental Health LLCGroup PAC ID 4082159629, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willamette Valley Mental Health LLC

  • Mental Health Counselor
  • Newberg, OR
  • NPI 1538936265
  Medicare reassignment Care Compare group NPD
• Willamette Valley Mental Health LLC

  • Mental Health Counselor
  • Newberg, OR
  • NPI 1528890621
  NPD
• NW Mind-Body Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, OR
  • NPI 1467969220
  NPD (past)

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1730548215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 SW 67TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238589",
            "telephone_number": "503-308-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 SW 67TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238589",
            "telephone_number": "503-308-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenric Brion Craver, PA
• CRC Health Oregon, LLC (Allied Health Services Tigard)
• Shakeria Credit
• Kimberly S Crihfield, MD
• Florence Cripe
• Richard Harold Crokin, DC
• Celene Cross
• Simone Anna Crothers, M.A.
• Priscilla Crowder
• Rebecca Crowder

• Professional Counselor in Tigard, OR
• Providers in Tigard, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.