CAROL LIPSON CRISWELL (NPI# 1053829663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053829663 |
| Entity Type | Individual |
| Full Name | CAROL LIPSON CRISWELL |
| Other Name | CAROL MARY LIPSON |
| Practice Address |
830 Ne 47th Ave Portland OR 97213-2212 |
| Mailing Address |
203 Se 45th Ave Portland OR 97215-1013 |
| Practice Telephone | 5032152429 |
| Mailing Telephone | 9712195799 |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OR | Other Service Providers |
| Street Address |
830 NE 47TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053408005 | Peter John Lax | Dentist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-09 |
| 1225521404 | Lydia Eve Jahn | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-06-12 |
| 1669970521 | Gabriela Barajas Quiroz | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-25 |
| 1649788241 | Diane Cervi | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2018-01-17 |
| 1740793579 | Katie Lynn Harris | Peer Specialist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-11-15 |
| 1629597935 | Paige Wollenzien | Dietitian, Registered | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2017-09-18 |
| 1831631753 | Darrick Stiff | Speech-Language Pathologist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-11-09 |
| 1871042044 | Rebecca Spencer | Speech-Language Pathologist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-28 |
| 1508313842 | Amy Grimm | Physical Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-02 |
| 1134676521 | Jennifer Victoria Morgan | Occupational Therapist | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2016-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on CAROL LIPSON CRISWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.