Individual provider Active NPI

Marylyn Estelle Crystal, MSW LCSW

  • Psychologist
  • Scarsdale, NY
National Provider Identifier
1730260712
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
003568 Issued in CT
Practice address
41 Black Birch LN
Scarsdale, NY 10583
Phone
(914) 472-2736
Fax
(914) 472-0474
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X RO29869-1 NY
Psychologist 103T00000X 003568 CT Primary
Clinical Social Worker 1041C0700X RO29869-1 NY
Clinical Social Worker 1041C0700X 003568 CT

Addresses

Primary practice location

41 Black Birch LN
Scarsdale, NY 10583

Mailing address

41 Black Birch LN
Scarsdale, NY 10583
Phone (914) 472-2736

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
003568CTMDProfessional Counselor
RO29869-1NYMDClinical Social Worker
029869NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1730260712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 BLACK BIRCH LN",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "10583",
            "telephone_number": "914-472-2736",
            "fax_number": "914-472-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 BLACK BIRCH LN",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "10583",
            "telephone_number": "914-472-2736",
            "fax_number": "914-472-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRYSTAL",
        "first_name": "MARYLYN",
        "middle_name": "ESTELLE",
        "name_prefix": "Mrs.",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "RO29869-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "003568",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO29869-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003568",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.