Individual provider Active NPI

Crystal Nneka Wiley

  • Social Worker
  • New York, NY
National Provider Identifier
1407791684
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
091687 Issued in NY
Practice address
111 Wadsworth Ave Apt 16C
New York, NY 10033-6116
Phone
(917) 822-0671
NPI assigned
Apr 22, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 091687 NY Primary

Addresses

Primary practice location

111 Wadsworth Ave Apt 16C
New York, NY 10033-6116

Mailing address

111 Wadsworth Ave Apt 16C
New York, NY 10033-6116
Phone (718) 378-0490

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Other Other

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

NPI Registry JSON

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

{
    "created_epoch": "1776816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1407791684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WADSWORTH AVE APT 16C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336116",
            "telephone_number": "718-378-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WADSWORTH AVE APT 16C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336116",
            "telephone_number": "917-822-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "CRYSTAL",
        "middle_name": "NNEKA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "091687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "endpointDescription": "Other",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "111 Wadsworth Ave Apt 16C",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100336116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.