Active NPI
Crystal Angerville, LMHC
- Mental Health Counselor
- Brooklyn, NY
National Provider Identifier
1104385574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 009400
- Practice address
- 151 Lawrence St FL 4
Brooklyn, NY 11201-5240 - Phone
- (917) 623-6801
- NPI assigned
- Mar 15, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 009400 | NY | Primary |
Addresses
Primary practice location
151 Lawrence St FL 4
Brooklyn, NY 11201-5240
Mailing address
275 Linden Blvd Apt E12
Brooklyn, NY 11226-3518
Phone (631) 793-8204
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009400 | Other | NY | DEPARTMENT OF THE PROFESSIONS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | cangerville@cases.org | Health Information Exchange (HIE) |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canino LCSW Psychotherapy PC | Multi-Specialty | Past | 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.
-
- Health Maintenance Organization
- Brooklyn, NY
- NPI 1225220072
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552608000000",
"number": "1104385574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 LINDEN BLVD APT E12",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112263518",
"telephone_number": "631-793-8204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 LAWRENCE ST FL 4",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015240",
"telephone_number": "917-623-6801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANGERVILLE",
"first_name": "CRYSTAL",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-15",
"last_updated": "2019-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "009400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF THE PROFESSIONS",
"identifier": "009400",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "cangerville@cases.org",
"affiliation": "N",
"endpointDescription": "e-mail",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "151 Lawrence St Fl 4",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112015240",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.