Individual provider Active NPI

Crystal Fickey, LICSW

  • Clinical Social Worker
  • Wenatchee, WA
National Provider Identifier
1972989358
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60833199 Issued in WA
Practice address
140 Easy Way
Wenatchee, WA 98801
Phone
(509) 662-4296
Fax
(509) 664-1037
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH60818946 WA
Clinical Social Worker 1041C0700X LW60833199 WA Primary

Addresses

Primary practice location

140 Easy Way
Wenatchee, WA 98801

Mailing address

600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone (509) 664-3527

Other identifiers 1

IdentifierTypeStateIssuer
2084497MedicaidWA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH60818946WAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1972989358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-664-3527",
            "fax_number": "509-664-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 EASY WAY",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "98801",
            "telephone_number": "509-662-4296",
            "fax_number": "509-664-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICKEY",
        "first_name": "CRYSTAL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60818946",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60833199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2084497",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; 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.