Individual provider Active NPI

Tyrone Dripps, CACD-1

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1962840389
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C4722 Issued in OR
Practice address
2001 Commercial St SE Ste 200
Salem, OR 97302-5207
Phone
(503) 370-8050
Fax
(503) 370-9982
NPI assigned
Jun 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12-06-17 OR
Professional Counselor 101YP2500X C4722 OR Primary

Addresses

Primary practice location

2001 Commercial St SE Ste 200
Salem, OR 97302-5207

Mailing address

2001 Commercial St SE Ste 200
Salem, OR 97302-5207
Phone (503) 370-8050

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240524003486 OR Practitioner - Mental Health Counselor 3072955723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Pastoral Counseling Center 16 clinicians

Practice addresses (Care Compare)

2001 Commercial St SE
Salem, OR 97302-5207
Phone 5033708050208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Pastoral Counseling Center Professional CurrentSince Apr 14, 2024 Accepting new patients

Locations

2001 Commercial St SE
Salem, OR 97302
Phone (503) 363-1500

2001 Commercial St SE
Ste 200
Salem, OR 97302
Phone (503) 370-8050

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": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1962840389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COMMERCIAL ST SE STE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025207",
            "telephone_number": "503-370-8050",
            "fax_number": "503-370-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COMMERCIAL ST SE STE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025207",
            "telephone_number": "503-370-8050",
            "fax_number": "503-370-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIPPS",
        "first_name": "TYRONE",
        "credential": "CACD-1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-07",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "12-06-17",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.