Provider Demographics
NPI:1790419810
Name:REEVE, CRYSTAL (LCSW)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:REEVE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11615 ANGUS RD STE 218
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4066
Mailing Address - Country:US
Mailing Address - Phone:616-581-8892
Mailing Address - Fax:
Practice Address - Street 1:11615 ANGUS RD STE 218
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4066
Practice Address - Country:US
Practice Address - Phone:616-581-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1039741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical