Individual provider Active NPI

Crystal Deboise, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1265978076
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082712-1 Issued in NY
Practice address
26 Court St
Ste. 1009
Brooklyn, NY 11242-0103
Phone
(917) 650-6615
NPI assigned
Jan 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082712-1 NY Primary

Addresses

Primary practice location

26 Court St
Ste. 1009
Brooklyn, NY 11242-0103

Mailing address

86 Beaver St
5J
Brooklyn, NY 11206-4576
Phone (917) 650-6615

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

LicenseStateTypeSpecialty
082712-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1265978076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 BEAVER ST",
            "address_2": "5J",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112064576",
            "telephone_number": "917-650-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST",
            "address_2": "STE. 1009",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112420103",
            "telephone_number": "917-650-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOISE",
        "first_name": "CRYSTAL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082712-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.