Individual provider Active NPI

Crystal Carithers, LCSW

  • Clinical Social Worker
  • Grayson, GA
National Provider Identifier
1376377614
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009262 Issued in GA
Practice address
2086 Leafmore CT
Grayson, GA 30017-4331
Phone
(706) 380-4392
NPI assigned
Aug 29, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 CSW009262 GA Primary

Addresses

Primary practice location

2086 Leafmore CT
Grayson, GA 30017-4331

Mailing address

2086 Leafmore CT
Grayson, GA 30017-4331
Phone (770) 868-7589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MA2 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

Enrollment IDStateProvider typePAC IDDetails
I20241011004028 GA Practitioner - Clinical Social Worker 1850823030 Reassigns benefits to 1 organization
I20241031002301 MA Practitioner - Clinical Social Worker 1850823030 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Aug 24, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1376377614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2086 LEAFMORE CT",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300174331",
            "telephone_number": "770-868-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2086 LEAFMORE CT",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300174331",
            "telephone_number": "706-380-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARITHERS",
        "first_name": "CRYSTAL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayson, GA

Sources for this page

Verify at the official NPI Registry.