Active NPI
Teri Lynn Cristal, LMSW
- Social Worker
- Edgefield, SC
National Provider Identifier
1205928728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6595
- Practice address
- 409 Simpkins St
Edgefield, SC 29824-1313 - Phone
- (803) 637-5788
- Fax
- (803) 637-0753
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6595 | SC | Primary |
Addresses
Primary practice location
409 Simpkins St
Edgefield, SC 29824-1313
Mailing address
1547 Parkway
Suite 100
Greenwood, SC 29646-4081
Phone (864) 229-7120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 421504 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6595 | SC | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | 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.
-
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1083421994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205928728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1547 PARKWAY",
"address_2": "SUITE 100",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296464081",
"telephone_number": "864-229-7120",
"fax_number": "864-229-5526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 SIMPKINS ST",
"city": "EDGEFIELD",
"state": "SC",
"postal_code": "298241313",
"telephone_number": "803-637-5788",
"fax_number": "803-637-0753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISTAL",
"first_name": "TERI",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": "6595",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "421504",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edgefield, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.