Individual provider Active NPI

Jazmine Tawanna Bennett Crumpton, MS, LCMHC, NCC

  • Professional Counselor
  • Winston Salem, NC
National Provider Identifier
1407304702
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11910 Issued in NC
Practice address
4045 University Pkwy Ste 225
Winston Salem, NC 27106-3325
Phone
(336) 496-2529
NPI assigned
Sep 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 11910 NC Primary

Addresses

Primary practice location

4045 University Pkwy Ste 225
Winston Salem, NC 27106-3325

Mailing address

4045 University Pkwy Ste 225
Winston Salem, NC 27106-3325
Phone (336) 496-2529

Other practice location 1

3143 S Stratford Rd
Winston Salem, NC 27103-5948
Phone (336) 496-2529

Other practice location 2

7670 N Point Ct
Winston Salem, NC 27106-3336
Phone (855) 362-8470

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11910NCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1407304702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 UNIVERSITY PKWY STE 225",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063325",
            "telephone_number": "336-496-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 UNIVERSITY PKWY STE 225",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063325",
            "telephone_number": "336-496-2529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3143 S Stratford Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271035948",
            "country_code": "US",
            "telephone_number": "336-496-2529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7670 N Point Ct",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271063336",
            "country_code": "US",
            "telephone_number": "855-362-8470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRUMPTON",
        "first_name": "JAZMINE",
        "middle_name": "TAWANNA BENNETT",
        "name_prefix": "Ms.",
        "credential": "MS, LCMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "11910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.