Chinna Krystal Iheakaram, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06421100 Issued in NJ

Practice address

11 S Key St
Sparta, NJ 07871-3507

Phone

(973) 207-4698

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1306502950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S KEY ST",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713507",
            "telephone_number": "973-207-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S KEY ST",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713507",
            "telephone_number": "973-207-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHEAKARAM",
        "first_name": "CHINNA",
        "middle_name": "KRYSTAL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05812600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06421100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Elizabeth Horn, D.O.
• Kerrianne Howland
• Emily Hullings, DPT
• Hunter Medical Inc
• Elshaimaa Ibrahim
• Kris Imbrie, MSW, LSW, DVS
• Patricia Inglett
• Integrated Psychological Services LLC
• Internal and Pulmonary Medicine Associates LLC
• Brandon Istvan

• Clinical Social Worker in Sparta, NJ
• Providers in Sparta, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.

Verify at the official NPI Registry.