Provider Demographics
NPI:1477858595
Name:CRABB-MCMIKEL, CRYSTAL (LCSW)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:CRABB-MCMIKEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:S
Other - Last Name:CRABB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 1030
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-1030
Mailing Address - Country:US
Mailing Address - Phone:580-298-2830
Mailing Address - Fax:
Practice Address - Street 1:107 S HIGH ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-3818
Practice Address - Country:US
Practice Address - Phone:580-298-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59091041C0700X
103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation