Individual provider Active NPI

Crystel Eatman, MSW

  • Social Worker
  • Fayetteville, AR
National Provider Identifier
1114185378
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1722 N College Ave Ste C
Fayetteville, AR 72703-2640
Phone
(502) 762-2672
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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 Primary

Addresses

Primary practice location

1722 N College Ave Ste C
Fayetteville, AR 72703-2640

Mailing address

1722 N College Ave Ste C
Fayetteville, AR 72703-2640
Phone (502) 762-2672

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

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1114185378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 N COLLEGE AVE STE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032640",
            "telephone_number": "502-762-2672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 N COLLEGE AVE STE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032640",
            "telephone_number": "502-762-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATMAN",
        "first_name": "CRYSTEL",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.