Crystal Moore, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M6567 Issued in MS

Practice address

9 Roux 61 Dr Ste C
Natchez, MS 39120-2176

Phone

(601) 897-8100

Fax

(601) 897-8111

NPI assigned

Mar 20, 2013

Last updated

Nov 27, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mississippi Behavioral Health Services, LLC

  • Community/Behavioral Health Agency
  • Jackson, MS
  • NPI 1396196879
  NPD (past)
• Southwest Mississippi Mental Health Mental Retardation Commission

  dba SW Ms Mental Health Region XI

  • Social Worker
  • McComb, MS
  • NPI 1366694820
  NPD (past)
• SW Ms Mental Health Mental Retardation Commission

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McComb, MS
  • NPI 1184662694
  NPD (past)

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1639411309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 E RIVER PL STE 100",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023442",
            "telephone_number": "769-251-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ROUX 61 DR STE C",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391202176",
            "telephone_number": "601-897-8100",
            "fax_number": "601-897-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 White St",
            "address_purpose": "LOCATION",
            "city": "McComb",
            "state": "MS",
            "postal_code": "396482711",
            "country_code": "US",
            "telephone_number": "601-684-2173",
            "fax_number": "601-249-4234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CRYSTAL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M6567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mississippi Nephrologists LLC
• Mississippi State Department of Health (Southwest Home Health Agency)
• Mississippi State Department of Health
• Mom and Pop Home Care Services LLC
• Monica's Hope ' Driving for a Cure' Transportation Services LLC
• Kimberly Nicole Moore
• Terese Morgan
• Morris Dental, LLC (Miss Lou Dental Creekside)
• Kirk Antonio Moses, M.D.
• Dawn Moss, PNP

• Social Worker in Natchez, MS
• Providers in Natchez, MS by specialty
• Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.