Individual provider Active NPI

Crystall M Sisco

  • Social Worker
  • Bowie, MD
National Provider Identifier
1669124301
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LG200001469 Issued in DC
Practice address
1607 Melford Blvd
Suite 400
Bowie, MD 20715-4305
Phone
(202) 878-6626
NPI assigned
Jan 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 28161 MD
Social Worker 104100000X LG200001469 DC Primary

Addresses

Primary practice location

1607 Melford Blvd
Suite 400
Bowie, MD 20715-4305

Mailing address

13324 Burleigh St
Upper Marlboro, MD 20774-1961
Phone (202) 498-4460

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LG200001469DCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Family Services Current Accepting new patients

Organizations & group practices 1

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": "1642982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1669124301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13324 BURLEIGH ST",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741961",
            "telephone_number": "202-498-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 MELFORD BLVD",
            "address_2": "SUITE 400",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154305",
            "telephone_number": "202-878-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISCO",
        "first_name": "CRYSTALL",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-24",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "28161",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG200001469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.