Krystal Anderson, LCSWA
Individual provider Active NPI Clinical Social Worker · Jacksonville, NC
NPI 1356897656 · NPPES record last updated Aug 28, 2016
Key facts
- NPI
- 1356897656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- P009218 (NC)
- Practice address
- 110-B Branchwood Drive
Jacksonville, NC 28546 - Phone
- (910) 938-9833
- NPI assigned
- Aug 28, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P009218 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pride in North Carolina, LLC | Past | Accepting new patients | |
| Easter Seals Ucp North Carolina & Virginia, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P009218 | NC | Yes |
Addresses
Primary practice location
110-B Branchwood Drive
Jacksonville, NC 28546
Mailing address
800 Talon Cir
Apt. 1E
Jacksonville, NC 28546-7167
Phone (910) 938-9833
Other providers in Jacksonville, NC
- Amanda Renee Amrine
- Anchor of Hope Therapy Services, PLLC
- Anchored Inc.
- Anderson and Slack PA
- Donna Ray Anderson
- Megan M Anderson
- Stephanie Rachel Anderson
- Naomi Billie Andrade
- Andre KS Tse MD PA
- Joseph Edward Andrews
All providers in Jacksonville, NC · Clinical Social Worker in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.