Provider Demographics
NPI:1609299445
Name:CRUSHSHON, NGONZI TRUTH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NGONZI
Middle Name:TRUTH
Last Name:CRUSHSHON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 CLAIRMONT RD STE 108
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4636
Mailing Address - Country:US
Mailing Address - Phone:732-733-6413
Mailing Address - Fax:
Practice Address - Street 1:1549 CLAIRMONT RD STE 108
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4636
Practice Address - Country:US
Practice Address - Phone:732-733-6413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health