Active NPI
Crystal Prestia, LCSW, CAP
- Social Worker
- Pembroke Pines, FL
National Provider Identifier
1962952226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW20973
- Practice address
- 1000 N Hiatus Rd Ste 120
Pembroke Pines, FL 33026-3094 - Phone
- (954) 651-3565
- Fax
- (754) 263-5932
- NPI assigned
- Oct 11, 2016
- Reactivated
- Mar 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ADC-009802-2015 | FL | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAP.0009802 | FL | |
| Social Worker | 104100000X | ISW15523 | FL | |
| Social Worker | 104100000X | SW20973 | FL | Primary |
Addresses
Primary practice location
1000 N Hiatus Rd Ste 120
Pembroke Pines, FL 33026-3094
Mailing address
1000 N Hiatus Rd Ste 120
Pembroke Pines, FL 33026-3094
Phone (954) 651-3565
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
| License | State | Type | Specialty |
|---|---|---|---|
| ADC-009802-2015 | FL | MD | Addiction (Substance Use Disorder) Counselor |
| CAP.0009802 | FL | MD | Addiction (Substance Use Disorder) Counselor |
| ISW15523 | FL | MD | Social Worker |
| SW20973 | FL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Change Happens, LLC | Social Worker | Current | Accepting new patients |
Locations
1000 N Hiatus Rd
Ste 120
Pembroke Pines, FL 33026
Phone (954) 651-3565
1931 NW 150th Ave
Ste 244
Pembroke Pines, FL 33028
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.
-
- Social Worker
- Pembroke Pines, FL
- NPI 1366140477
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1962952226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N HIATUS RD STE 120",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330263094",
"telephone_number": "954-651-3565",
"fax_number": "754-263-5932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N HIATUS RD STE 120",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330263094",
"telephone_number": "954-651-3565",
"fax_number": "754-263-5932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESTIA",
"first_name": "CRYSTAL",
"name_prefix": "Mrs.",
"credential": "LCSW, CAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-11",
"last_updated": "2023-09-05",
"certification_date": "2023-03-28",
"deactivation_date": "2019-08-15",
"reactivation_date": "2021-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "FL",
"license": "ADC-009802-2015",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "FL",
"license": "CAP.0009802",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "ISW15523",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "FL",
"license": "SW20973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.