Individual provider Active NPI

Crysta Fletcher, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1003205121
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1000115 Issued in OH
Practice address
3284 North Bend Rd
Suite 314
Cincinnati, OH 45239-7688
Phone
(513) 481-2432
Fax
(513) 662-2432
NPI assigned
Jan 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I1000115 OH Primary

Addresses

Primary practice location

3284 North Bend Rd
Suite 314
Cincinnati, OH 45239-7688

Mailing address

4760 Madison Rd
Cincinnati, OH 45227-1426
Phone (513) 861-0035

Other names 1

  • Crysta Lovin Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1000115OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Hanley PHD Clinical PastSince Jul 1, 2012 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": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1003205121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 MADISON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452271426",
            "telephone_number": "513-861-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3284 NORTH BEND RD",
            "address_2": "SUITE 314",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452397688",
            "telephone_number": "513-481-2432",
            "fax_number": "513-662-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "CRYSTA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1000115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTA",
            "last_name": "LOVIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; 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.