Crystalynn De la Cruz, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009966 Issued in CT

Practice address

867 Main St Ste 5
Manchester, CT 06040-6034

Phone

(860) 325-2541

NPI assigned

Jun 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1962896548
  NPD (past)

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

{
    "created_epoch": "1338681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1831450121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 MAIN ST STE 5",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406034",
            "telephone_number": "860-966-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 MAIN ST STE 5",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406034",
            "telephone_number": "860-325-2541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "61 Alps Drive",
            "address_2": "InterCommunity, Inc.",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "061180611",
            "country_code": "US",
            "telephone_number": "860-569-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1680 Albany Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051001",
            "country_code": "US",
            "telephone_number": "860-236-4511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "CRYSTALYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-03",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "098293052",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquia Davis
• Peta-Gaye Davis
• Rochelle L Davis
• Tonya R Davis
• Janet M Day
• Daniel Deakins, NMD
• Deborah a Ellison Aprn LLC
• Deanne Debrady-Williams
• Shawn Decarish
• Tracy Decarli

• Clinical Social Worker in Manchester, CT
• Providers in Manchester, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.