Individual provider Active NPI

Rachel McCrystal, LICSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1508395286
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
555 N Main St
Providence, RI 02904-5722
Phone
(401) 684-8602
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

555 N Main St
Providence, RI 02904-5722

Mailing address

65 Sage Dr
Cranston, RI 02921-3525

Other practice location 1

66 Troy St
Fall River, MA 02720-3023
Phone (508) 676-5708

Other practice location 2

186 Providence St
West Warwick, RI 02893-2508
Phone (401) 615-2800

Other identifiers 1

IdentifierTypeStateIssuer
ISW03107OtherRIRI LICSW LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200406001725 MA Practitioner - Clinical Social Worker 0749619195 Reassigns benefits to 1 organization
I20210921002319 RI Practitioner - Clinical Social Worker 0749619195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Wellness Counseling Clinical Current Accepting new patients
Thundermist Health Center CurrentSince Aug 30, 2021 Accepting new patients
Thundermist Health Center CurrentSince Aug 30, 2021 Accepting new patients
Child & Family Services, Inc. CurrentSince Feb 2, 2020 Accepting new patients

Locations

3057 Acushnet Ave
New Bedford, MA 02745
Phone (508) 742-1040

965 Church St
New Bedford, MA 02745
Phone (508) 996-3154

1061 Pleasant St
New Bedford, MA 02740
Phone (508) 996-8572

186 Providence St
West Warwick, RI 02893
Phone (401) 615-2800

450 Clinton St
Woonsocket, RI 02895

25 John a Cummings Way
Ste 302
Woonsocket, RI 02895

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 4

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1508395286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 SAGE DR",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029213525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045722",
            "telephone_number": "401-684-8602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Troy St",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027203023",
            "country_code": "US",
            "telephone_number": "508-676-5708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "186 Providence St",
            "address_purpose": "LOCATION",
            "city": "West Warwick",
            "state": "RI",
            "postal_code": "028932508",
            "country_code": "US",
            "telephone_number": "401-615-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCRYSTAL",
        "first_name": "RACHEL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI LICSW LICENSE",
            "identifier": "ISW03107",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.