NPIMap

Individual provider Active NPI

Cipriano Juarez, CADC II, CGAC II

  • Addiction (Substance Use Disorder) Counselor
  • Beaverton, OR
National Provider Identifier
1962873612
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
23-05-20275 Issued in OR
Practice address
3800 SW Cedar Hills Blvd Ste 170
Beaverton, OR 97005-2020
Phone
(503) 626-1800
NPI assigned
Oct 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X G17-P-01 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 23-05-20275 OR Primary

Addresses

Primary practice location

3800 SW Cedar Hills Blvd Ste 170
Beaverton, OR 97005-2020

Mailing address

3800 SW Cedar Hills Blvd Ste 170
Beaverton, OR 97005-2020
Phone (503) 626-1800

Other identifiers 4

IdentifierTypeStateIssuer
23-05-20275OtherORMHACBO CADC-II
14-P-02OtherORMHACBO CADC-I
G17-P-01OtherORMHACBO CGAC-II
500693890MedicaidOR

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
G17-P-01ORMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Group NW LLC Counselor Past Accepting new patients

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": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1962873612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SW CEDAR HILLS BLVD STE 170",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052020",
            "telephone_number": "503-626-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SW CEDAR HILLS BLVD STE 170",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052020",
            "telephone_number": "503-626-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "CIPRIANO",
        "credential": "CADC II, CGAC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "G17-P-01",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "23-05-20275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO CADC-II",
            "identifier": "23-05-20275",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO CADC-I",
            "identifier": "14-P-02",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO CGAC-II",
            "identifier": "G17-P-01",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500693890",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.

Verify at the official NPI Registry.