Individual provider Active NPI

Crystal Anita Patrick - Jefferson, MSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1841514015
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P022950 Issued in NC
Practice address
204 Muirs Chapel Rd Ste 126
Greensboro, NC 27410-6173
Phone
(336) 638-1933
NPI assigned
Mar 17, 2010
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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 P022950 NC Primary

Addresses

Primary practice location

204 Muirs Chapel Rd Ste 126
Greensboro, NC 27410-6173

Mailing address

4200 NW 3Rd CT Apt 328
Plantation, FL 33317-2815
Phone (954) 583-1207

Other practice location 1

3500 N State Road 7
Suite 211-212
Lauderdale Lakes, FL 33319-5600
Phone (954) 578-8399

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

LicenseStateTypeSpecialty
P022950NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1841514015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 NW 3RD CT APT 328",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172815",
            "telephone_number": "954-583-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MUIRS CHAPEL RD STE 126",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274106173",
            "telephone_number": "336-638-1933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 N State Road 7",
            "address_2": "Suite 211-212",
            "address_purpose": "LOCATION",
            "city": "Lauderdale Lakes",
            "state": "FL",
            "postal_code": "333195600",
            "country_code": "US",
            "telephone_number": "954-578-8399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK - JEFFERSON",
        "first_name": "CRYSTAL",
        "middle_name": "ANITA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P022950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.