Individual provider Active NPI

Crystal Marie Tapia, LCSW

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1104298181
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-08156 Issued in NM
Practice address
2001 E Lohman Ave Ste 110
Las Cruces, NM 88001-3197
Phone
(575) 520-0887
Fax
(575) 524-4813
NPI assigned
Oct 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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 I-08156 NM Primary

Addresses

Primary practice location

2001 E Lohman Ave Ste 110
Las Cruces, NM 88001-3197

Mailing address

2001 E Lohman Ave
Ste 110
Las Cruces, NM 88001-3197
Phone (575) 520-0887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160928001822 NM Practitioner - Clinical Social Worker 7113214578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1090 Crossley LN
Las Cruces, NM 88005-3841
Phone (575) 520-0887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-08156NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Clarity Counseling, LLC Clinical CurrentSince Mar 1, 2018 Accepting new patients
Organ Mountain Counseling, LLC Clinical Past Accepting new patients

Locations

2001 E Lohman Ave
Ste 110
Las Cruces, NM 88001
Phone (575) 520-0887

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.

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1104298181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 E LOHMAN AVE",
            "address_2": "STE 110",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013197",
            "telephone_number": "575-520-0887",
            "fax_number": "575-524-4813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E LOHMAN AVE STE 110",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013197",
            "telephone_number": "575-520-0887",
            "fax_number": "575-524-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPIA",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-29",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-08156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.