Crystal Burts, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW6558 Issued in FL

Practice address

921 N Davis St
Building B Suite 350
Jacksonville, FL 32209-6804

Phone

(904) 337-1247

Fax

(904) 798-4763

NPI assigned

Nov 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Crystal Deanna Gavin Former name

Medicare fee-for-service enrollment

Enrolled in NC

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 1

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  Single Specialty

  Medicare reassignment NPD
• Port Health Services

  • Counselor
  • Greenville, NC
  • NPI 1497075618

  Single Specialty

  Medicare reassignment NPD
• Port Health Services

  • Community/Behavioral Health Agency
  • Whiteville, NC
  • NPI 1174005789
  NPD
• Port Health Services

  • Counselor
  • Greenville, NC
  • NPI 1477538254
  NPD

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

{
    "created_epoch": "1385164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1316377658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "WEIRSDALE",
            "state": "FL",
            "postal_code": "321950204",
            "telephone_number": "904-400-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 N DAVIS ST",
            "address_2": "BUILDING B SUITE 350",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096804",
            "telephone_number": "904-337-1247",
            "fax_number": "904-798-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTS",
        "first_name": "CRYSTAL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-23",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14735",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW6558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "GAVIN",
            "middle_name": "DEANNA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marqisha L Burton
• Megan Frank Burton, AUD
• Sarah Ellen Burton, L.M.T.
• Theresa Burton
• Abigail Elizabeth Burtone, OTR
• Alexanderia Octavia Burwell, ARNP-BC
• Evan Michael Busby, D.M.D.
• Laurie Lee Buschini, A.R.N.P.
• Laura Brimhall Buschle, PTA
• Brianna Bush

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.