Provider Demographics
NPI:1841765930
Name:RAUSO, CRYSTAL (LMHPC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:RAUSO
Suffix:
Gender:F
Credentials:LMHPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 THE GRN STE 8540
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:302-689-3874
Mailing Address - Fax:
Practice Address - Street 1:626 CLIFTON DR
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-2149
Practice Address - Country:US
Practice Address - Phone:302-981-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2023-02-12
Deactivation Date:2021-11-09
Deactivation Code:
Reactivation Date:2022-12-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health