Active NPI
Crystal Williams, LCSW
- Clinical Social Worker
- Stone Mountain, GA
National Provider Identifier
1225452915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 004751
- Practice address
- 721 Valley View Dr
Stone Mountain, GA 30087-3936 - Phone
- (708) 465-4467
- Fax
- (708) 465-4467
- NPI assigned
- Feb 14, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 004751 | GA | Primary |
| Behavior Analyst | 103K00000X |
Addresses
Primary practice location
721 Valley View Dr
Stone Mountain, GA 30087-3936
Mailing address
721 Valley View Dr
Stone Mountain, GA 30087-3936
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 |
|---|---|---|---|
| 004751 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552348800000",
"number": "1225452915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "721 VALLEY VIEW DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300873936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 VALLEY VIEW DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300873936",
"telephone_number": "708-465-4467",
"fax_number": "708-465-4467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "CRYSTAL",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-14",
"last_updated": "2019-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "004751",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.