Individual provider Active NPI

Crystle Dawn Feliciano

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1689429532
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11198-C Issued in NV
Practice address
4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600
Phone
(702) 653-2273
NPI assigned
Apr 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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 11198-C NV Primary

Addresses

Primary practice location

4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600

Mailing address

4700 Las Vegas Blvd N
Las Vegas, NV 89191-6600
Phone (720) 652-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20251204001428 NV Practitioner - Clinical Social Worker 5496248734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4040 N Martin Luther King Blvd
North Las Vegas, NV 89032

725 W Town and Country Rd
Orange, CA 92868-4703

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11198-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Christian Health Center Corp CurrentSince Nov 10, 2025 Accepting new patients
Hope Christian Health Center Corp Current Accepting new patients
Hope Christian Health Center Corp CurrentSince Nov 10, 2025 Accepting new patients

Locations

4040 N Martin L King Blvd
Ste A
North Las Vegas, NV 89032
Phone (702) 644-4673

4357 Corporate Center Dr
Ste 450
North Las Vegas, NV 89030
Phone (702) 644-4673

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFGHCA

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": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1689429532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "720-652-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "CRYSTLE",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "11198-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.