Crystal Lynn Conley, LCSW

Key facts

NPI

1013209790

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

Q1-0000603 (DE)

Practice address

2099 S Dupont Hwy
Dover, DE 19901-5568

Phone

(302) 674-1600

Fax

(302) 531-0850

NPI assigned

May 12, 2011

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• People'S Place II, Inc. Mental Health Clinic/Center (Including Community Mental Health Center) · Milford, DE · NPI 1295871481
  Medicare reassignment Care Compare group DE
• Catholic Charities Inc Mental Health Counselor · Wilmington, DE · NPI 1033142617
  NPD (past) CLINICAL

Medicare Care Compare profile

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

People'S Place II, Inc. (18 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 12, 2011.

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1013209790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 S DUPONT HWY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199015568",
            "telephone_number": "302-674-1600",
            "fax_number": "302-531-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2099 S DUPONT HWY",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199015568",
            "telephone_number": "302-674-1600",
            "fax_number": "302-531-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000603",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11114",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Dover, DE · Clinical Social Worker in Delaware