Crystal Rene Jackson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

230241 Issued in MA

Practice address

123 Main Street
60538
Florence, MA 01062

Phone

(857) 259-1722

NPI assigned

Feb 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jack Bruno Other name

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Transhealth, Inc.

  • Internal Medicine Physician
  • Florence, MA
  • NPI 1053913525
  Medicare reassignment

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1730944273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 MAIN STREET",
            "address_2": "60538",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "01062",
            "telephone_number": "857-259-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MAIN STREET",
            "address_2": "60538",
            "city": "FLORENCE",
            "state": "MA",
            "postal_code": "01062",
            "telephone_number": "857-259-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "CRYSTAL",
        "middle_name": "RENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "230241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "BRUNO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Margaret Lisle Hudson, D.C.
• Rubina Husain, RDN
• Yvonne Elaine Hutchinson, LMSW
• Ian E Modestow, DMD
• Colleen M Isabelle, OPTICIAN
• Nancy B Jessup, LICSW
• Joseph Deschene DMD LLC
• David R Kalman, M.D.
• David Kaufman, M.D.
• Patricia Marie Keeley, LCSW

• Clinical Social Worker in Florence, MA
• Providers in Florence, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.