Kristy Lynn Staten, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C8956 Issued in MS

Practice address

506 W Marion Ave Ste a
Crystal Springs, MS 39059-2720

Phone

(601) 497-8242

NPI assigned

Sep 23, 2020

Last updated

Sep 23, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristy.staten.p1@direct.magnoliamedical.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthy Heart and Mind Behavioral Health Services, LLC

  • Clinical Social Worker
  • Crystal Springs, MS
  • NPI 1194493858
  Authorized official Same address or phone
• PSP Medical Clinic

  dba Flowood Family Clinic

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1245502723
  NPD
• PSP Medical Clinic LLC

  dba Madison Canton Medical Clinic

  • Rural Health Clinic/Center
  • Canton, MS
  • NPI 1932144243
  NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1093321192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 TANK RD",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391708394",
            "telephone_number": "601-951-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W MARION AVE STE A",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592720",
            "telephone_number": "601-497-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "KRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Redonda Smith
• Jennifer Mach Sojourner, CFNP
• Southwest Pharmacy Inc (Guy's Pharmacy of Crystal Springs)
• Specialty Medical Supply of Mississippi, Inc.
• Thomas Edward Spell Jr., R.PH.
• Stovall Transportation LLC
• Frank Stovall
• Glen H Stribling, OD
• Tina Andrea Tanner
• Tender Care Nursing

• Clinical Social Worker in Crystal Springs, MS
• Providers in Crystal Springs, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.