Active NPI
Crystal Newkirk Jones, LCSW, LISW-CP
- Clinical Social Worker
- West Columbia, SC
National Provider Identifier
1235417775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11789
- Practice address
- 160 Medical Cir FL 1
West Columbia, SC 29169-3639 - Phone
- (803) 796-6811
- Fax
- (803) 796-6851
- NPI assigned
- Aug 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P005855 | NC | |
| Clinical Social Worker | 1041C0700X | C008599 | NC | |
| Clinical Social Worker | 1041C0700X | 11789 | SC | Primary |
Addresses
Primary practice location
160 Medical Cir FL 1
West Columbia, SC 29169-3639
Mailing address
747 Edenhall Dr
Columbia, SC 29229-7092
Phone (919) 368-2417
Other practice location 1
501 Billingsley Rd
Suite B
Charlotte, NC 28211-1009
Phone (704) 444-2400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235417775 | Medicaid | NC | |
| SW1296 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
160 Medical Cir
FL 1
West Columbia, SC 29169-3639
Phone 803796681111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P005855 | NC | MD | Clinical Social Worker |
| 11789 | SC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Psychiatric Services, Inc | Clinical | Current | Accepting new patients |
Locations
160 Medical Cir
Fl 1
West Columbia, SC 29169
Phone (803) 796-6811
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1235417775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "747 EDENHALL DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292297092",
"telephone_number": "919-368-2417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 MEDICAL CIR FL 1",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291693639",
"telephone_number": "803-796-6811",
"fax_number": "803-796-6851"
}
],
"practiceLocations": [
{
"address_1": "501 Billingsley Rd",
"address_2": "Suite B",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282111009",
"country_code": "US",
"telephone_number": "704-444-2400",
"fax_number": "704-358-2716",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JONES",
"first_name": "CRYSTAL",
"middle_name": "NEWKIRK",
"credential": "LCSW, LISW-CP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-02",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P005855",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C008599",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "11789",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235417775",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SW1296",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.