Individual provider Active NPI

Crystal Rios, MS, LMFT

  • Marriage & Family Therapist
  • Moore, OK
National Provider Identifier
1891012522
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1159 Issued in OK
Practice address
400 N Eastern Ave
Moore, OK 73160-5833
Phone
(405) 659-5858
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1159 OK Primary

Addresses

Primary practice location

400 N Eastern Ave
Moore, OK 73160-5833

Mailing address

1925 Metlock LN
Moore, OK 73160-5639
Phone (405) 659-5858

Other identifiers 1

IdentifierTypeStateIssuer
200389120 CMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20231121003763 OK Practitioner - Marriage and Family Therapist 9133575707 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1159OKMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Family Therapy CurrentSince Aug 23, 2023 Accepting new patients

Locations

7530 NW 23rd St
Bethany, OK 73008
Phone (405) 730-6990

1400 SE 4th St
Ste A
Moore, OK 73160
Phone (405) 794-4497

1400 SE 4th St
Moore, OK 73160
Phone (405) 790-0300

400 N Eastern Ave
Moore, OK 73160
Phone (405) 601-4303

Organizations & group practices 1

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": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1891012522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 METLOCK LN",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605639",
            "telephone_number": "405-659-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N EASTERN AVE",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731605833",
            "telephone_number": "405-659-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "CRYSTAL",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OK",
            "license": "1159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200389120 C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.