Krystal Lee Souza, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

RN261257 Issued in MA

Practice address

31A Workshop Rd
South Yarmouth, MA 02664-1210

Phone

(508) 398-5155

Fax

(508) 398-3478

NPI assigned

May 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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

• Habit Opco, LLC

  • Methadone Clinic
  • Springfield, MA
  • NPI 1023175072
  NPD (past)
• Habit Opco, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fitchburg, MA
  • NPI 1255034880
  NPD (past)

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1447833686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31A WORKSHOP RD",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026641210",
            "telephone_number": "508-398-5155",
            "fax_number": "508-398-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31A WORKSHOP RD",
            "city": "SOUTH YARMOUTH",
            "state": "MA",
            "postal_code": "026641210",
            "telephone_number": "508-398-5155",
            "fax_number": "508-398-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "KRYSTAL",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "RN261257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kumara Sidhartha, MD
• Samuel Vieira Silva
• Amy Slowey
• Elexxis E Smith
• South Yarmouth Management Systems Inc
• Hannah Spitz
• Star and Fox Pediatrics
• Ashley Jadene Stevens, O.D.
• Rachel Marie Stevens
• Alyssa Claire Stpierrearguello

• Addiction (Substance Use Disorder) Registered Nurse in South Yarmouth, MA
• Providers in South Yarmouth, MA by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.