Individual provider Active NPI

Suzanne Maria Lee Crawford Natysin, LICSW

  • Clinical Social Worker
  • New Brighton, MN
National Provider Identifier
1174283113
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19214 Issued in MN
Practice address
900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414
Phone
(612) 706-9630
NPI assigned
Dec 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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 19214 MN Primary

Addresses

Primary practice location

900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414

Mailing address

1420 Bradley St
Saint Paul, MN 55130-3404
Phone (651) 428-1791

Other practice location 1

4826 Chicago Ave Ste 105
Minneapolis, MN 55417-1055
Phone (612) 827-3028

Other names 1

  • Suzanne Maria Lee Crawford Professional name

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

State licenses

LicenseStateTypeSpecialty
19214MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Wellness Collaborative CurrentSince Dec 21, 2021 Accepting new patients
Medical Care Services, PA CurrentSince Dec 21, 2021 Accepting new patients
Center for Child Abuse Prevention and Treatment Past Accepting new patients

Locations

900 Long Lake Rd
Ste 160
Saint Paul, MN 55112
Phone (612) 706-9630

Organizations & group practices 3

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": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1174283113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 BRADLEY ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303404",
            "telephone_number": "651-428-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4826 Chicago Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554171055",
            "country_code": "US",
            "telephone_number": "612-827-3028",
            "fax_number": "612-823-4993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NATYSIN",
        "first_name": "SUZANNE",
        "middle_name": "MARIA LEE CRAWFORD",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "CRAWFORD",
            "middle_name": "MARIA LEE",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in New Brighton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.