Crista Lyn Pervelis, LCSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

078407-1 Issued in NY

Practice address

101 Fireplace Neck Road
Brookhaven, NY 11719

Phone

(631) 730-1700

NPI assigned

Oct 13, 2011

Last updated

Oct 13, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Crista Lyn Hasler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1265717078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 FIREPLACE NECK ROAD",
            "city": "BROOKHAVEN",
            "state": "NY",
            "postal_code": "11719",
            "telephone_number": "631-730-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FIREPLACE NECK ROAD",
            "city": "BROOKHAVEN",
            "state": "NY",
            "postal_code": "11719",
            "telephone_number": "631-730-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERVELIS",
        "first_name": "CRISTA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "078407-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTA",
            "last_name": "HASLER",
            "middle_name": "LYN",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Miller, MS CCC/SLP
• Gina M Mitchell, LPN
• Kayla Anne Muglia, LCSW
• Lynette Alice Murphy, LMSW
• Karen Ann Ossip, R.N.
• Physical Therapy Alternatives
• Annette F Racaniello, DO
• Ramsammy Medical PC
• Terence Joseph Reilly
• Lynne Scheibel, PT

• School Social Worker in Brookhaven, NY
• Providers in Brookhaven, NY by specialty
• School Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.