CRYSTAL CLARK


Address: 3400 State St # 750, Salem, OR 97301-5861
Phone: 9712737502

CRYSTAL CLARK (NPI# 1801259619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801259619
Entity Type Individual
Full Name CRYSTAL CLARK
Practice Address 3400 State St # 750
Salem
OR 97301-5861
Mailing Address 21600 Oxnard St Ste 1800
Woodland Hills
CA 91367-7807
Practice Telephone 9712737502
Mailing Telephone 8183452345
Enumeration Date 2016-03-30
Last Update Date 2020-01-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 247200000X Technician, Other Technologists, Technicians & Other Technical Service Providers
Y 103K00000X Behavioral Analyst Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
15930 19 Mile Rd, Suite 150, Clinton Twp, MI 480381155 5864640175
229 N Sheldon Rd, Plymouth, MI 48170 3132784601
2814 Woodcliff Cir Se, Grand Rapids, MI 49506 8558326727

Other Providers CRYSTAL CLARK

NPI Name Taxonomy Address Enumeration
1619581311 Crystal Clark Massage Therapist 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 2020-09-01
1366068470 Crystal Sherase Clark Technician 4429 Grant St Ne, Washington, DC 20019-4739 2020-06-24
1467014894 Crystal Clark Chore Provider 153 Brambury Dr Apt D, Rochester, NY 14621-1820 2019-07-06
1386112050 Crystal Lynn Clark Internal Medicine 12056 224th St, Cambria Heights, NY 11411-2141 2018-11-11
1154898179 Crystal B Clark Family Medicine 112 Woodland Drive, Lancaster, SC 29720 2018-10-29
1467829911 Crystal Lynn Clark Specialist/Technologist 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 2015-08-31
1386073070 Crystal Shawn Clark Nurse Anesthetist, Certified Registered 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 2013-11-04
1417391160 Crystal Joan Clark Nurse Practitioner 11930 Arbor St Ste 200, Omaha, NE 68144-2998 2013-04-24
1952677700 Crystal Nache Clark Counselor 13902 Sage Thrasher Lane, Riverview, FL 33579 2012-03-27
1639443658 Crystal A Clark Chore Provider 331 Jamestown Ct, Columbus, OH 43228-4030 2012-03-08

Office Location

Street Address 3400 STATE ST # 750
City SALEM
State OR
Zip Code 97301-5861

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750947693 Kyler Hart Southcott Behavior Technician 3400 State St # 750, Salem, OR 97301-5861 2019-05-16
1003308834 Alize Markson Behavior Technician 3400 State St # 750, Salem, OR 97301-5861 2018-06-06
1811492473 Jace Isaac Cureton Behavioral Analyst 3400 State St # 750, Salem, OR 97301-5861 2018-03-27

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205450970 Jehan Seals Behavior Technician 3400 State St Set G750, Salem, OR 97301 2020-05-29
1093335929 Sterling Recovery, LLC Dietitian, Registered 3758 Amber St Ne #105, Salem, OR 97301 2020-04-21
1760018360 Riverfront Mental Health LLC Counselor 338 State St, Suite 985, Salem, OR 97301 2020-03-16
1871126888 Amity Beth Haddon Maxwell Social Worker Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 2020-02-18
1861042632 Brenda Grizelda Vargas Behavioral Analyst 3400 State Ste Ste G750, Salem, OR 97301 2019-09-13
1588213177 Natalie Stone Registered Nurse 2045 Siverton Rd Ne, Salem, OR 97301 2019-09-06
1588228720 Jeramy Disenso Counselor 270 Cottage St Ne, Salem, OR 97301 2019-04-23
1801353297 Gwendolyn Kersey Registered Nurse 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 2019-02-21
1841769114 Spine Clinic PC Massage Therapist 1281 Lancaster Drive Ne, Salem, OR 97301 2018-11-16
1013482132 Kellie Linn Hansen Physical Therapist 4049 Market St Se, Salem, OR 97301 2018-10-04
Find all providers in zip 97301

Taxonomy Information

Taxonomy Code 103K00000X
Grouping Behavioral Health & Social Service Providers
Classification Behavioral Analyst

Taxonomy Definition

A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154940153 Erin Elise Bily-luton Behavioral Analyst 403 W Mcmackin St, Salem, IL 62881-1724 2020-04-10
1487293437 Shannon Demi Behavioral Analyst 434 Forsyth Rd, Salem, CT 06420-4018 2019-12-21
1215579768 Kaitlyn Holkenbrink Behavioral Analyst 3400 State St # G-760, Salem, OR 97301-5861 2019-10-16
1235770447 Annette M Steiner Behavioral Analyst 3400 State St Ste G7503400, Salem, OR 97301-5861 2019-09-30
1861042632 Brenda Grizelda Vargas Behavioral Analyst 3400 State Ste Ste G750, Salem, OR 97301 2019-09-13
1215585328 Maggie Lynne Beans Behavioral Analyst 2826 Fisher Rd Ne Apt 43, Salem, OR 97305-1318 2019-09-01
1093271751 Maribel Bermudez Behavioral Analyst 1266 Orchard Heights Rd Nw, Salem, OR 97304-2512 2019-02-18
1760947626 Isabelle Marie Grinstead Behavioral Analyst 108 Marlborough Rd, Salem, MA 01970-1065 2019-02-05
1376012609 Stacy Ann Jackson Behavioral Analyst 3762 Amber St Ne Apt 102, Salem, OR 97301-6883 2018-11-15
1316414816 Ashley Smith Behavioral Analyst 1774 Madras St Se, Salem, OR 97306-1394 2018-11-01
Find all providers in SALEM

Competitor

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City SALEM
Zip Code 97301

Improve Information

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Dataset Information

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.

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