Active NPI
Crystal Angela Wilson, LMSW
- Social Worker
- Jamaica, NY
National Provider Identifier
1740825785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10828401
- Practice address
- 8974 162ND St Ste 3
Jamaica, NY 11432-5012 - Phone
- (718) 526-2400
- NPI assigned
- Nov 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10828401 | NY | Primary |
Addresses
Primary practice location
8974 162ND St Ste 3
Jamaica, NY 11432-5012
Mailing address
2232 Loretta Rd FL 2
Far Rockaway, NY 11691-2537
Phone (917) 808-1050
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10828401 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cartwheel Health Services PC | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Cambridge, MA
- NPI 1912633975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573603200000",
"number": "1740825785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2232 LORETTA RD FL 2",
"city": "FAR ROCKAWAY",
"state": "NY",
"postal_code": "116912537",
"telephone_number": "917-808-1050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8974 162ND ST STE 3",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114325012",
"telephone_number": "718-526-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CRYSTAL",
"middle_name": "ANGELA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-13",
"last_updated": "2019-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "10828401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.