Provider Demographics
NPI:1225315104
Name:JONES, CRYSTAL ERLENE (MHC)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:ERLENE
Last Name:JONES
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:ERLENE
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHC
Mailing Address - Street 1:1094 GLENWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2910
Mailing Address - Country:US
Mailing Address - Phone:518-275-8009
Mailing Address - Fax:
Practice Address - Street 1:845 CENTRAL AVE
Practice Address - Street 2:SOUTH 3
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1514
Practice Address - Country:US
Practice Address - Phone:518-458-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health