Individual provider Active NPI

Monique Crutchfield, LCSW

  • Mental Health Counselor
  • Greensboro, NC
National Provider Identifier
1487975595
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C006190 Issued in NC
Practice address
2010 Gramercy Park Dr
Greensboro, NC 27406-8566
Phone
(336) 442-5458
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C006190 NC Primary

Addresses

Primary practice location

2010 Gramercy Park Dr
Greensboro, NC 27406-8566

Mailing address

2010 Gramercy Park Dr
Greensboro, NC 27406-8566
Phone (336) 442-5458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000564 NC Practitioner - Clinical Social Worker 4082877832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Counseling and DevelopmentGroup PAC ID 9133487499, 2 clinicians

Practice addresses (Care Compare)

4917 Piedmont Pkwy
Suite 104
Jamestown, NC 27282-7536
Phone (336) 493-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051056NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Counseling and Development CurrentSince Sep 15, 2017 Accepting new patients

Locations

4917 Piedmont Pkwy
Ste 103D
Jamestown, NC 27282
Phone (336) 442-5458

4917 Piedmont Pkwy
Ste 104
Jamestown, NC 27282
Phone (336) 493-5600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1487975595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 GRAMERCY PARK DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274068566",
            "telephone_number": "336-442-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 GRAMERCY PARK DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274068566",
            "telephone_number": "336-442-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUTCHFIELD",
        "first_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C006190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.