Individual provider Active NPI

Crystal Ann Dussia, LMSW

  • Clinical Social Worker
  • Plymouth, MI
National Provider Identifier
1649896358
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801104067 Issued in MI
Practice address
484 Deer St
Plymouth, MI 48170-1747
Phone
(810) 813-0271
NPI assigned
Jun 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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 6801104067 MI Primary

Addresses

Primary practice location

484 Deer St
Plymouth, MI 48170-1747

Mailing address

1403 Borgstrom Ave
Ypsilanti, MI 48198-6407
Phone (810) 813-0271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20201229003002 MI Practitioner - Clinical Social Worker 9133532625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801104067MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Clear Counseling & Consultation PLLC Clinical CurrentSince Nov 18, 2025 Accepting new patients
LDBT, LLC Clinical CurrentSince Oct 1, 2025 Accepting new patients
Detroit Recovery Project PastSince Jun 21, 2020 Accepting new patients

Locations

484 Deer St
Plymouth, MI 48170
Phone (734) 301-1662

878 Grove Rd
Ste Ul
Ypsilanti, MI 48198
Phone (734) 985-8001

Organizations & group practices 3

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": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761955200000",
    "number": "1649896358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 BORGSTROM AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481986407",
            "telephone_number": "810-813-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 DEER ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701747",
            "telephone_number": "810-813-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSSIA",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.