MEDICARE: CRYSTAL N HUTCHINSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	18711	FL

General Provider Information

NPI Number	:	1477210946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL N HUTCHINSON LCSW

Provider Business Mailing Address
First Line	:	902 20TH PL
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960
Country	:	US
Telephone Number	:	772-519-6387
Fax Number	:

Provider Business Practice Location Address
First Line	:	902 20TH PL
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-3296
Country	:	US
Telephone Number	:	772-519-6387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	11/19/2021

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