Provider Demographics
NPI:1598464596
Name:VAN WINKLE, CRYSTAL CATHERINE (LMHP)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:CATHERINE
Last Name:VAN WINKLE
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 ROGER WELSCH AVE E
Mailing Address - Street 2:
Mailing Address - City:DANNEBROG
Mailing Address - State:NE
Mailing Address - Zip Code:68831-3165
Mailing Address - Country:US
Mailing Address - Phone:308-390-9745
Mailing Address - Fax:
Practice Address - Street 1:411 ROGER WELSCH AVE E
Practice Address - Street 2:
Practice Address - City:DANNEBROG
Practice Address - State:NE
Practice Address - Zip Code:68831-3165
Practice Address - Country:US
Practice Address - Phone:308-390-9745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5396101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health