CRYSTAL CLARK (NPI# 1801259619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
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 |
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 |
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 |
Street Address |
3400 STATE ST # 750 |
City | SALEM |
State | OR |
Zip Code | 97301-5861 |
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 |
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 Code | 103K00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Behavioral Analyst |
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] |
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 |
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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.