Provider Demographics
NPI:1235919671
Name:MIDDLETON, CRISTAL FAITH (CASAC-T, CRPA-P)
Entity Type:Individual
Prefix:
First Name:CRISTAL
Middle Name:FAITH
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:CASAC-T, CRPA-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 MONTAUK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-2435
Mailing Address - Country:US
Mailing Address - Phone:347-785-1571
Mailing Address - Fax:
Practice Address - Street 1:770 E 176TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4617
Practice Address - Country:US
Practice Address - Phone:347-785-1571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)