Individual provider Active NPI

Debra Irizarry, ATR-BC, LCAT

  • Art Therapist
  • Salem, OR
National Provider Identifier
1740731959
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
ART-C-10234736 Issued in OR
Practice address
3750 Chemawa Rd NE
Salem, OR 97305-1119
Phone
(503) 304-7600
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X ART-C-10234736 OR Primary

Addresses

Primary practice location

3750 Chemawa Rd NE
Salem, OR 97305-1119

Mailing address

1956 Linwood St NW Apt 2048
Salem, OR 97304-2586
Phone (631) 612-0723

Other identifiers 1

IdentifierTypeStateIssuer
33855391MedicaidNM

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
ART-C-10234736ORMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1740731959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 LINWOOD ST NW APT 2048",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973042586",
            "telephone_number": "631-612-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051119",
            "telephone_number": "503-304-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY",
        "first_name": "DEBRA",
        "credential": "ATR-BC, LCAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "OR",
            "license": "ART-C-10234736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33855391",
            "state": "NM"
        }
    ],
    "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 Apr 23, 2024; 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.