Patricia Jennie Crandall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14253 Issued in FL

Practice address

107 Dr Martin Luther King Jr Ave Ste 1
Inverness, FL 34450-4300

Phone

(800) 539-4228

Fax

(352) 565-4131

NPI assigned

Mar 16, 2017

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: patriciajennie.crandall.p1@direct.smahealthcare.nextgenshare.com

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.

• Sma Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Daytona Beach, FL
  • NPI 1356329163
  Medicare reassignment NPD
• Sma Healthcare, Inc

  • Federally Qualified Health Center (FQHC)
  • Daytona Beach, FL
  • NPI 1255950168
  NPD
• Lifestream Behavioral Center Inc

  • Primary Care Clinic/Center
  • Leesburg, FL
  • NPI 1659613776
  NPD (past)
• Sma Healthcare Inc

  • Psychiatric Hospital
  • Daytona Beach, FL
  • NPI 1750369666
  NPD (past)

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1568903003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MAGNOLIA AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144304",
            "telephone_number": "386-236-3225",
            "fax_number": "352-565-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DR MARTIN LUTHER KING JR AVE STE 1",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344504300",
            "telephone_number": "800-539-4228",
            "fax_number": "352-565-4131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3238 S Lecanto Hwy",
            "address_purpose": "LOCATION",
            "city": "Lecanto",
            "state": "FL",
            "postal_code": "344619025",
            "country_code": "US",
            "telephone_number": "352-621-1068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "PATRICIA",
        "middle_name": "JENNIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Steven Cook, O.D.
• Shaun Tyler Cook
• William Burgess Cook, MD
• Michelle Covino, PHARMD
• Craig W. Englund, MD, PA
• Sarah Caitlyn Crawford, MD
• Creative Pathways Therapy, LLC
• Patrick Timothy Crisler, OTA 6857
• Jennafer Rae Critchfield
• Ryan William Cromwell, MD

• Clinical Social Worker in Inverness, FL
• Providers in Inverness, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.