CRYSTAL ROSE WISS
NPI 1265262612
Counselor - Professional in Lebanon, OR

Active since August 01, 2024PECOS EnrolledAccepts Medicare Assignment
1600 S MAIN ST, LEBANON, OR 97355(541) 451-5932(541) 812-8807 Get Directions Write a Review

NPPES record last updated: August 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Crystal Rose Wiss NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL ROSE WISS (NPI 1265262612) is an individual professional provider in Lebanon, Oregon, licensed in Oregon (C8013) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1265262612
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameCRYSTAL ROSE WISS
Location Address1600 S MAIN STLebanon, OR 97355-3109
Mailing AddressPo Box 100Albany, OR 97321-0031 · (541) 967-3866 · Fax (541) 812-8807
Fax(541) 812-8807
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateAugust 1, 2024
NPPES CertifiedAugust 1, 2024
✔ NPI 1265262612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OR · C8013
1600 S MAIN ST, Lebanon, OR 97355

Other Names 1

Former Name (1)Crystal Rose Haskins

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Crystal Rose Wiss is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113468778
PECOS Enrollment IDI20240923002494
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Crystal Wiss reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mental Health (Including Community Mental Health Center)
139 SW 3RD ST
Corvallis, OR 97333
  • Reassigned Medicare billing, Oregon enrollment
  • 3 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse
1600 S MAIN ST
LEBANON, OR 97355
Counselor (Mental Health)
1600 S MAIN ST
LEBANON, OR 97355
Counselor (Mental Health)
1600 S MAIN ST
LEBANON, OR 97355
Psychologist (Forensic)
1600 S MAIN ST
LEBANON, OR 97355
Social Worker (Clinical)
1600 S MAIN ST
LEBANON, OR 97355
Case Manager/Care Coordinator
1600 S MAIN ST
LEBANON, OR 97355
Counselor (Mental Health)
1600 S MAIN ST
LEBANON, OR 97355
Registered Nurse (Community Health)
1600 S MAIN ST
LEBANON, OR 97355

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Wiss's NPI number?

The NPI number for Crystal Wiss is 1265262612. It was assigned to this individual provider in the NPPES registry on August 1, 2024. The provider is also known as Crystal Rose Haskins.

Where is Crystal Wiss located?

Crystal Wiss practices at 1600 S Main St, Lebanon, OR 97355. The listed phone number is (541) 451-5932.

What is Crystal Wiss's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Crystal Wiss enrolled in Medicare?

Yes. Crystal Wiss is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Crystal Wiss's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Wiss reassigns Medicare benefits to Conifer Wellness, Inc. (Corvallis, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Crystal Wiss's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Crystal Wiss accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Crystal Wiss as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crystal Wiss was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.