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

Individual provider Clinical Social Worker · NPI 1417201989

Krystal Penman Mangandi, LCSW is a Clinical Social Worker in Charlotte, North Carolina. Qualified in 2000, 26 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
26
Licensed in
NC
In the registry since
2012
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

5855 Executive Center Dr Ste 111
Charlotte, NC 28212-8883
Phone: (704) 537-1202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C008071 (NC)

Record details

NPI number1417201989
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 5, 2012
Last updated in NPPESMarch 19, 2013

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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