Provider Demographics
NPI:1619523040
Name:KNOOP, CRYSTAL SUSETTE (LPC)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:SUSETTE
Last Name:KNOOP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:SUSETTE
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2838 PANAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418
Mailing Address - Country:US
Mailing Address - Phone:361-877-4982
Mailing Address - Fax:361-452-3180
Practice Address - Street 1:5151 FLYNN PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-446-0646
Practice Address - Fax:361-452-3180
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional