Individual provider Active NPI

Crystal Lynette Walter, LCSW

  • Clinical Social Worker
  • Bellaire, TX
National Provider Identifier
1740620434
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
53946 Issued in TX
Practice address
6500 West Loop S Ste 200-C
Bellaire, TX 77401-3535
Phone
(713) 486-1303
NPI assigned
Jun 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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 53946 TX
Clinical Social Worker 1041C0700X 53946 TX Primary

Addresses

Primary practice location

6500 West Loop S Ste 200-C
Bellaire, TX 77401-3535

Mailing address

PO Box 31478
Houston, TX 77231-1478
Phone (832) 439-7319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220131002177 TX Practitioner - Clinical Social Worker 6507259363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

2021 Guadalupe St
Suite 260
Austin, TX 78705-5654
Phone (866) 630-0966

6410 Fannin St
Houston, TX 77030-3005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53946TXMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jun 6, 2024 Accepting new patients

Locations

2021 Guadalupe St
Ste 260
Austin, TX 78705
Phone (202) 932-9958

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": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1740620434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31478",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772311478",
            "telephone_number": "832-439-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 WEST LOOP S STE 200-C",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013535",
            "telephone_number": "713-486-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "CRYSTAL",
        "middle_name": "LYNETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "53946",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "53946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

Verify at the official NPI Registry.