CRYSTAL EDWARDS (NPI# 1205335064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205335064 |
Entity Type | Individual |
Full Name | CRYSTAL EDWARDS |
Other Name | CRYSTAL HUMEL |
Practice Address |
903 W Lincoln Ave Charleston IL 61920-2413 |
Practice Telephone | 2173488384 |
Mailing Telephone | 2173488384 |
Enumeration Date | 2018-02-07 |
Last Update Date | 2018-02-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
34419 | IL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | FEIN | 743113035 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275154338 | Crystal Edwards | Massage Therapist | 2718 Medgar Evers Blvd, Jackson, MS 39213-7257 | 2020-04-30 |
1528449212 | Crystal Lavonne Edwards | Community/Behavioral Health | 11010 W Madison St, Avondale, AZ 85323-3340 | 2015-06-18 |
1336304278 | Crystal Hayse Edwards | Massage Therapist | 1469 33rd Cir Se, Rio Rancho, NM 87124-1915 | 2008-07-21 |
1992795041 | Crystal Edwards | Physician Assistant | 4390 Fayetteville Rd, Lumberton, NC 28358-2677 | 2005-10-28 |
1336799907 | Crystal Edwards | Behavior Technician | 421 Fayetteville St Ste 1100, Raleigh, NC 27601-3000 | 2019-09-16 |
1356907422 | Crystal Sue Edwards | Social Worker | 133 E Swanson Ave, Wasilla, AK 99654 | 2019-05-14 |
1639633134 | Crystal J Edwards | Speech-Language Pathologist | 965 Fisher Rd, Many, LA 71449-3819 | 2019-01-29 |
1346763018 | Crystal Kay Edwards | Counselor | 117 W Medical Ct, Marion, NC 28752-5590 | 2017-07-25 |
1225400260 | Crystal Edwards | Occupational Therapist | 38 W 32nd St Ste 604, New York, NY 10001-3884 | 2015-10-29 |
1760742969 | Crystal L Edwards | Psychologist | 480 Alta Rd, San Diego, CA 92179-0001 | 2012-05-22 |
Street Address |
903 W LINCOLN AVE |
City | CHARLESTON |
State | IL |
Zip Code | 61920-2413 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
Find all providers in zip 61920 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578172870 | Seri Bosse | Counselor | 1506 Kanawha Blvd W, Charleston, WV 25387-2533 | 2020-07-23 |
1881245710 | 3 Days Rising, Inc. | Counselor | 720 Magnolia Rd Ste 20, Charleston, SC 29407-7094 | 2019-09-23 |
1770133902 | Leah Kelley | Counselor | 900 Christopher St, Charleston, WV 25301-1201 | 2019-09-19 |
1609362391 | Ten Up Ministries, Inc | Counselor | 6697 Rocky Fork Road, Charleston, WV 25312 | 2018-07-05 |
1861983652 | Chelsie Smith | Counselor | 1182 Dover Rd, Charleston, ME 04422-3031 | 2018-05-29 |
1306366679 | First Choice Services | Counselor | 601 Morris St Ste 401, Charleston, WV 25301-1416 | 2017-06-27 |
1225560790 | Jewell Allyson Carrington | Counselor | 1500 Parklawn Dr, Charleston, SC 29414-8130 | 2017-04-03 |
1013465855 | Hope Hartz | Counselor | 1632 Kanawha Blvd E, Charleston, WV 25311-2115 | 2016-09-21 |
1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
1003275488 | Janet Hilderbrand | Counselor | 7509 Charleston Pike, Charleston, IN 47111 | 2016-02-15 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 61920 |
Please comment or provide details below to improve the information on CRYSTAL EDWARDS.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.