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CREYSTAL DEMI FAGBOHUN LCSW
NPI 1689408031
Social Worker - Clinical in Marietta, GA

Active since August 28, 2024PECOS EnrolledAccepts Medicare Assignment
3126 RICH RD, MARIETTA, GA 30066(770) 903-2150 Get Directions Write a Review

NPPES record last updated: August 28, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Creystal Demi Fagbohun Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREYSTAL DEMI FAGBOHUN LCSW (NPI 1689408031) is an individual clinical provider in Marietta, Georgia, licensed in Georgia (CSW007521) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1689408031
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameCREYSTAL DEMI FAGBOHUNCredential: LCSW
Location Address3126 RICH RDMarietta, GA 30066-3802
Mailing Address3126 Rich RdMarietta, GA 30066-3802 · (770) 903-2150
Phone(770) 903-2150
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateAugust 28, 2024
NPPES CertifiedAugust 28, 2024
✔ NPI 1689408031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in GA · CSW007521
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3126 RICH RD, Marietta, GA 30066
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Oscar Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Creystal Demi Fagbohun Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840728937
PECOS Enrollment IDI20250117000923
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Creystal Fagbohun reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mental Health Specialty Group PA
346 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Georgia enrollment
  • 232 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088
Grow Healthcare Group PA
625 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Florida and Georgia enrollments
  • 3,079 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.84 – $172.43
Typical copayment $0.00 (range $14.21 – $43.10)
Most-billed visit code NA
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MINDFUL HEALING COUNSELING & THERAPY SERVICES, LLC
Social Worker (Clinical)
3126 RICH RD
MARIETTA, GA 30066
Cobb County (770) 903-2150

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Creystal Fagbohun's NPI number?

The NPI number for Creystal Fagbohun is 1689408031. It was assigned to this individual provider in the NPPES registry on August 28, 2024.

Where is Creystal Fagbohun located?

Creystal Fagbohun practices at 3126 Rich Rd, Marietta, GA 30066. The listed phone number is (770) 903-2150.

What is Creystal Fagbohun's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Creystal Fagbohun enrolled in Medicare?

Yes. Creystal Fagbohun is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Creystal Fagbohun's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Creystal Fagbohun reassigns Medicare benefits to 2 organizations: Mental Health Specialty Group PA (Durham, NC) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Creystal Fagbohun's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Creystal Fagbohun accept?

Health plans from CareSource, Oscar Health and UnitedHealthcare list Creystal Fagbohun as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Creystal Fagbohun was last updated on August 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.