Individual provider Active NPI

Crystal Irene Smigielski, LLBSW

  • Clinical Social Worker
  • Clinton Township, MI
National Provider Identifier
1710291539
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6802086720 Issued in MI
Practice address
44899 Centre CT
Suite 102
Clinton Township, MI 48038-5510
Phone
(586) 792-1654
Fax
(586) 792-1656
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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 6802086720 MI Primary

Addresses

Primary practice location

44899 Centre CT
Suite 102
Clinton Township, MI 48038-5510

Mailing address

44899 Centre CT
Suite 102
Clinton Township, MI 48038-5510
Phone (586) 792-1654

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
6802086720MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Joak American Homes, Inc. PastSince Sep 8, 2009 Accepting new patients
County of Macomb Past Accepting new patients

Organizations & group practices 2

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1710291539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44899 CENTRE CT",
            "address_2": "SUITE 102",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385510",
            "telephone_number": "586-792-1654",
            "fax_number": "586-792-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44899 CENTRE CT",
            "address_2": "SUITE 102",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480385510",
            "telephone_number": "586-792-1654",
            "fax_number": "586-792-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIGIELSKI",
        "first_name": "CRYSTAL",
        "middle_name": "IRENE",
        "credential": "LLBSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6802086720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.