Individual provider Active NPI

Crystal Dawn Durrett, LCSW

  • Clinical Social Worker
  • Eureka, CA
National Provider Identifier
1982871844
Registry record updated Jan 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 25570 Issued in CA
Practice address
427 F St Ste 234
Eureka, CA 95501-1037
Phone
(707) 954-7060
NPI assigned
May 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW 19042 CA
Clinical Social Worker 1041C0700X LCSW 25570 CA Primary

Addresses

Primary practice location

427 F St Ste 234
Eureka, CA 95501-1037

Mailing address

427 F St Ste 234
Eureka, CA 95501-1037
Phone (707) 954-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201208000896 CA Practitioner - Clinical Social Worker 4183036643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

427 F St
Suite 234
Eureka, CA 95501-1037
Phone (707) 717-9599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW 19042CAMDClinical Social Worker
LCSW 25570CAMDClinical Social Worker
25570CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Durrett, Licensed Clinical Social Worker, PC CurrentSince Jul 17, 2020 Accepting new patients
Remi Vista, Inc. Past Accepting new patients

Locations

508 H St
Ste 3
Crescent City, CA 95531
Phone (707) 465-1585

427 F St
Ste 234
Eureka, CA 95501
Phone (707) 954-7060

427 F St
Ste 223
Eureka, CA 95501
Phone (650) 733-3245

Organizations & group practices 2

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": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706400000000",
    "number": "1982871844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 F ST STE 234",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011037",
            "telephone_number": "707-954-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 F ST STE 234",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011037",
            "telephone_number": "707-954-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURRETT",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-09",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 19042",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW 25570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.