Provider Demographics
NPI:1922605948
Name:BOYLES, CRYSTAL (LMHC, LPCC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:BOYLES
Suffix:
Gender:F
Credentials:LMHC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7422 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-9356
Mailing Address - Country:US
Mailing Address - Phone:319-529-9913
Mailing Address - Fax:
Practice Address - Street 1:7422 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-9356
Practice Address - Country:US
Practice Address - Phone:319-529-9913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC04122101YM0800X
IA096806101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health