Provider Demographics
NPI:1689903254
Name:BIGGS, CRYSTAL CORSHE' (LMSW, PCMHT)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:CORSHE'
Last Name:BIGGS
Suffix:
Gender:F
Credentials:LMSW, PCMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-0526
Mailing Address - Country:US
Mailing Address - Phone:601-859-8371
Mailing Address - Fax:601-859-5433
Practice Address - Street 1:103 SOUTHLAKE CIR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-5369
Practice Address - Country:US
Practice Address - Phone:601-859-8371
Practice Address - Fax:601-859-5433
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000007841104100000X
MS5022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker