Individual provider Active NPI

Crystal D Colina, MSW, LCSW, MCAPI

  • Clinical Social Worker
  • Stuart, FL
National Provider Identifier
1437683984
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15127 Issued in FL
Practice address
2801 SE Martin Square Corporate Pkwy
Stuart, FL 34994-4916
Phone
(772) 444-7911
NPI assigned
Apr 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X SW15127 FL Primary

Addresses

Primary practice location

2801 SE Martin Square Corporate Pkwy
Stuart, FL 34994-4916

Mailing address

1026 SW Sultan Dr
Port Saint Lucie, FL 34953-2645
Phone (864) 275-8398

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

State licenses

LicenseStateTypeSpecialty
SW15127FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1437683984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 SW SULTAN DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532645",
            "telephone_number": "864-275-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 SE MARTIN SQUARE CORPORATE PKWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944916",
            "telephone_number": "772-444-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLINA",
        "first_name": "CRYSTAL",
        "middle_name": "D",
        "credential": "MSW, LCSW, MCAPI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-11",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.