Crystal Jean Carraway, LCSW
Individual provider Active NPI Clinical Social Worker · Camden, SC
NPI 1245487149 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1245487149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C007363 (NC)
- Practice address
- 119 Seegars Mill Rd
Camden, SC 29020-8129 - Phone
- (910) 465-7194
- NPI assigned
- Aug 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
490 Springhill Church Rd
Hamlet, NC 28345-7039
Phone (910) 465-7194
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150115001338 | NC | Practitioner - Clinical Social Worker | 5991029233 |
Reassigns benefits to 1 organization Practice locations: Hamlet, NC |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW7948 | TN | MD | Social Worker |
| P005548 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Social Worker | 104100000X | LSW7948 | TN | |
| Clinical Social Worker | 1041C0700X | P005548 | NC | |
| Clinical Social Worker | 1041C0700X | C007363 | NC | Yes |
Addresses
Primary practice location
119 Seegars Mill Rd
Camden, SC 29020-8129
Mailing address
119 Seegars Mill Rd
Camden, SC 29020-8129
Phone (910) 465-7194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6007917 | Medicaid | NC |
Other names
- Crystal Jean Holman
Other providers in Camden, SC
- Carolina Cardiovascular Consultants LLC
- Carolina Cataract Clinic
- Carolina Consortium of Care, LLC
- Carolina Orthotics and Prosthetics LLC
- Carolina Podiatry Clinic LLC
- Raven Simone Carraway
- Kenneth W. Carson
- Christopher Thomas Catalano
- Allison Catoe Wright
- Center of Change
All providers in Camden, SC · Clinical Social Worker in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.