Krystal Kirk, LLMSW

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Practice address

8090 Pinehurst St
Detroit, MI 48204-3160

Phone

(313) 717-7651

NPI assigned

Apr 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1780039693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9329 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391260",
            "telephone_number": "313-850-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8090 PINEHURST ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482043160",
            "telephone_number": "313-717-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "KRYSTAL",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Lynn Kintz, FNP-BC
• Stephanie Kioko, DDS
• S George Kipa, M.D.
• Mary Kathryn Kirby, M.S. CCC-SLP
• Samadhi Upeka Kiridena, MD
• Marquise Kirk
• Quanicia Latricie Kirk
• Marcy Elaine Kirkland, LMSW
• Tanisha Kirkland
• Vicki Ann Kirkman

• Case Management Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Case Management Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.

Verify at the official NPI Registry.