Individual provider Active NPI

Kristina Lynn Crepeau, LMSW

  • Social Worker
  • Clinton Township, MI
National Provider Identifier
1003255829
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801094766 Issued in MI
Practice address
40824 Michael St
Clinton Township, MI 48038-3073
Phone
(248) 285-0378
NPI assigned
Jun 14, 2013
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801094766 MI Primary

Addresses

Primary practice location

40824 Michael St
Clinton Township, MI 48038-3073

Mailing address

40824 Michael St
Clinton Township, MI 48038-3073
Phone (248) 285-0378

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801094766MIMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1003255829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40824 MICHAEL ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383073",
            "telephone_number": "248-285-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40824 MICHAEL ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383073",
            "telephone_number": "248-285-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREPEAU",
        "first_name": "KRISTINA",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801094766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.