Individual provider Active NPI

Crystal Nicole Ponce de Leon

  • Social Worker
  • Auburn Hills, MI
National Provider Identifier
1184180606
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802090292 Issued in MI
Practice address
1270 Doris Rd
Auburn Hills, MI 48326-2617
Phone
(248) 276-8000
NPI assigned
Feb 20, 2019
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 6802090292 MI Primary

Addresses

Primary practice location

1270 Doris Rd
Auburn Hills, MI 48326-2617

Mailing address

5111 Auto Club Dr Ste 112
Dearborn, MI 48126-2684
Phone (248) 276-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260305003432 MI Practitioner - Clinical Social Worker 3870075021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Easterseals Morc Health Care, IncGroup PAC ID 9830141670, 129 clinicians

Practice addresses (Care Compare)

5111 Auto Club Dr
Suite 112
Dearborn, MI 48126-2684
Phone (248) 536-5085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802090292MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. CurrentSince Feb 2, 2026 Accepting new patients

Locations

5111 Auto Club Dr
Ste 112
Dearborn, MI 48126
Phone (313) 317-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1184180606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR STE 112",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262684",
            "telephone_number": "248-276-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 DORIS RD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262617",
            "telephone_number": "248-276-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE DE LEON",
        "first_name": "CRYSTAL",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802090292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

Verify at the official NPI Registry.