Individual provider Active NPI

Pamela G. Crookston, MSW, LCSW

  • Clinical Social Worker
  • Sacaton, AZ
National Provider Identifier
1649258146
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LMSW-276 Issued in AZ
Practice address
483 W. Seed Farm Rd.
Sacaton, AZ 85247
Phone
(602) 528-1340
Fax
(602) 528-1296
NPI assigned
Jan 4, 2006
Last updated
Apr 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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 LMSW-276 AZ Primary

Addresses

Primary practice location

483 W. Seed Farm Rd.
Sacaton, AZ 85247

Mailing address

PO Box 115
Sacaton, AZ 85247-0115
Phone (602) 528-1340

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-276AZMDClinical Social Worker
10479AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1649258146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "852470115",
            "telephone_number": "602-528-1340",
            "fax_number": "602-528-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM RD.",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85247",
            "telephone_number": "602-528-1340",
            "fax_number": "602-528-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOKSTON",
        "first_name": "PAMELA",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LMSW-276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacaton, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.