Provider Demographics
NPI:1437525169
Name:CLAY, CRYSTAL (MS, LCDC, CART)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:CLAY
Suffix:
Gender:F
Credentials:MS, LCDC, CART
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 HIGHWAY 6
Mailing Address - Street 2:SUITE 230 #189
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4876
Mailing Address - Country:US
Mailing Address - Phone:832-782-0001
Mailing Address - Fax:
Practice Address - Street 1:2323 S VOSS RD
Practice Address - Street 2:STE. 367
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3814
Practice Address - Country:US
Practice Address - Phone:832-782-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12748101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)