Provider Demographics
NPI:1609505783
Name:CRIM, CRYSTAL ILENE (LPC, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:ILENE
Last Name:CRIM
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-5201
Mailing Address - Country:US
Mailing Address - Phone:205-572-7390
Mailing Address - Fax:
Practice Address - Street 1:601 BEACON PKWY W STE 201
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3123
Practice Address - Country:US
Practice Address - Phone:205-536-7811
Practice Address - Fax:205-870-3522
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP5596-R101YP2500X
ALLPC04965101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional