Chrystal Dawn Liebold-Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

77002 Issued in CA

Practice address

4529 Saint Davids St Unit 101
Philadelphia, PA 19127-1216

Phone

(646) 957-4294

NPI assigned

Jun 8, 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 PA, CA, FL, NY4 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 4

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chrystalliebold@tdh.allscriptsdirect.net

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.

• Sondermind PC

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1003646977
  Medicare reassignment NPD
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  FL

  Medicare reassignment NPD
• Sondermind, P.a.

  • Clinical Social Worker
  • Wichita, KS
  • NPI 1710647581

  PA

  Medicare reassignment NPD
• Wagner Medical PC

  • Clinical Social Worker
  • Toms River, NJ
  • NPI 1235951187

  NY

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NY

  Medicare reassignment
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1578092979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 SAINT DAVIDS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271216",
            "telephone_number": "646-957-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4529 SAINT DAVIDS ST UNIT 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271216",
            "telephone_number": "646-957-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBOLD-JOHNSON",
        "first_name": "CHRYSTAL",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy N Liebman, DPT
• Catherine Alanna Liebman, D.O.
• Erica Liebman, PSYD
• Jared J Liebman, M.D.
• Ronald Liebman, MD
• Nathan Liebsch, MD
• Carl Nelson Liedman, D.O.
• Jasper Y Liem, LCSW
• Marina Dewi Liem, MD
• Long Lieu

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.