Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristal Rayne Etsitty

Individual provider Clinical Social Worker · NPI 1245705946

Kristal Rayne Etsitty is a Clinical Social Worker in Phoenix, Arizona. Qualified in 2019, 7 years ago. Licensed in Arizona.

Years since qualifying
7
Licensed in
AZ
In the registry since
2018

Practice location Address checks out

4041 N Central Ave
Phoenix, AZ 85012-3330
Phone: (602) 279-5262
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-23289 (AZ)

Record details

NPI number1245705946
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 9, 2018
Last updated in NPPESSeptember 29, 2025
Certification dateSeptember 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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