CRYSTAL NICOLE FACTOR (DSW, MSW, LCSW) – Clinical Social Worker, NPI 1992138614
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
628 CLINICAL SOCIAL WORKER in OK
Provider Addresses for CRYSTAL NICOLE FACTOR (DSW, MSW, LCSW)
1300 HOPPE BLVD.
SUITE 1
ADA, OK 74820
Phone: (580) 436-7214
Fax: (580) 272-5757
Type: Mailing
1726 N. GREEN AVENUE
PURCELL, OK 73080
Phone: (405) 767-8940
Fax: (405) 767-8950
Type: Location
14440 Olympic Drive
Clearlake, CA 954228809
Phone: (707) 263-8383
Fax: (707) 263-5019
Type: Location
1726 N. Green Avenue
Purcell, OK 73080
Phone: (405) 767-8940
Fax: (405) 767-8950
Type: Location
925 Bevins Court
Lakeport, CA 954539754
Phone: (707) 263-8383
Fax: (707) 263-5019
Type: Location
10309 GREENBRIAR PKWY STE 1
OKLAHOMA CITY, OK 731597648
Phone: (405) 802-9992
Type: Mailing
10309 GREENBRIAR PKWY
OKLAHOMA CITY, OK 731597648
Phone: (405) 802-9992
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-01-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250102001924 | I | Clinical Social Worker | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74820)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Marriage And Family Therapist | CA | |
| Family Practice | CA | |
| Physical Medicine And Rehabilitation | CO | |
| Marriage And Family Therapist | CA | |
| Family Practice | CA | |
| Anesthesiology, Pain Management | CA | |
| O P H T H A L M O L O G Y | IA | |
| Clinical Social Worker | MD | |
| - | CA | |
| Clinical Social Worker | CA |
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