Individual provider Active NPI

Crystal Elaine Mullen-Johnson, LICSW, PIP,

  • Clinical Social Worker
  • Birmingham, AL
National Provider Identifier
1548799166
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1332-3980C Issued in AL
Practice address
2024 3Rd Ave N Ste 312
Birmingham, AL 35203-3302
Phone
(205) 721-9893
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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 1332-3980C AL Primary

Addresses

Primary practice location

2024 3Rd Ave N Ste 312
Birmingham, AL 35203-3302

Mailing address

601 Hickory St
Birmingham, AL 35206-1616
Phone (205) 913-6078

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
1332-3980CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Strive Counseling Services, L.L.C. Clinical Past Accepting new patients

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1548799166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HICKORY ST",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352061616",
            "telephone_number": "205-913-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 3RD AVE N STE 312",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352033302",
            "telephone_number": "205-721-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN-JOHNSON",
        "first_name": "CRYSTAL",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "LICSW, PIP,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1332-3980C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; 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.