Individual provider Active NPI

Crystal Titterington, LCSW

  • Clinical Social Worker
  • Urbana, MO
National Provider Identifier
1811659196
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2024000452 Issued in MO
Practice address
406 S Dallas St
Urbana, MO 65767-9144
Phone
(417) 993-1002
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2024000452 MO Primary

Addresses

Primary practice location

406 S Dallas St
Urbana, MO 65767-9144

Mailing address

PO Box 125
Hermitage, MO 65668-0125
Phone (417) 745-0103

Other practice location 1

18614 Jackson St
Hermitage, MO 65668-8204
Phone (417) 745-2121

Other names 1

  • Crystal Jordan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20250627002079 MO Practitioner - Clinical Social Worker 5799298345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Resource Group CurrentSince Aug 1, 2025 Accepting new patients
Ozarks Resource Group CurrentSince Aug 1, 2025 Accepting new patients

Locations

18614 Jackson St
Hermitage, MO 65668
Phone (417) 745-0103

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": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1811659196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680125",
            "telephone_number": "417-745-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S DALLAS ST",
            "city": "URBANA",
            "state": "MO",
            "postal_code": "657679144",
            "telephone_number": "417-993-1002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18614 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Hermitage",
            "state": "MO",
            "postal_code": "656688204",
            "country_code": "US",
            "telephone_number": "417-745-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TITTERINGTON",
        "first_name": "CRYSTAL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024000452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "JORDAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Urbana, MO

Sources for this page

Verify at the official NPI Registry.