Crystal Devon McCormick, LCSW

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1053 Issued in AK

Practice address

1867 Airport Way
Suite 200
Fairbanks, AK 99701-4054

Phone

(907) 590-2100

NPI assigned

Nov 26, 2012

Last updated

Mar 23, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Making a Difference Support Services, LLC

  • Clinical Social Worker
  • Fairbanks, AK
  • NPI 1013424225
  Medicare reassignment NPD Authorized official
• Making a Difference Support Services

  • Clinical Social Worker
  • Fairbanks, AK
  • NPI 1558715391
  NPD (past) Authorized official

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1790029114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "SUITE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014054",
            "telephone_number": "907-750-7169",
            "fax_number": "907-490-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 AIRPORT WAY",
            "address_2": "SUITE 200",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014054",
            "telephone_number": "907-590-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "CRYSTAL",
        "middle_name": "DEVON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "1053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Stickney McClure, LMT
• Emily Anise McCombs, OTD
• Morgan McConnaughhay, SLP
• Kendra McConnell
• Caroline Rose McCormick
• Geoffry McCormick
• Sylvia Ann McCormick, P.A.
• Jensyn McCray
• Cameron Ray McCullough
• Jalon Alexander McCullough

• Professional Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Professional Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.