Provider Demographics
NPI:1669662490
Name:AMUNDSON, CRYSTAL V (MS, LCPC, RPT-S)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:V
Last Name:AMUNDSON
Suffix:
Gender:F
Credentials:MS, LCPC, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 AVENUE C APT C
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3200
Mailing Address - Country:US
Mailing Address - Phone:406-461-4632
Mailing Address - Fax:
Practice Address - Street 1:1220 AVENUE C APT C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3200
Practice Address - Country:US
Practice Address - Phone:406-763-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-1549101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health