Provider Demographics
NPI:1841599461
Name:HARTMAN, CRYSTAL BETH (MA LPC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:BETH
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 S PARKER RD
Mailing Address - Street 2:640
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2736
Mailing Address - Country:US
Mailing Address - Phone:720-384-7837
Mailing Address - Fax:
Practice Address - Street 1:2851 S PARKER RD
Practice Address - Street 2:640
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2736
Practice Address - Country:US
Practice Address - Phone:720-384-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76682218Medicaid
CO52055841Medicaid