Provider Demographics
NPI:1922736586
Name:BILLMAN, CRYSTAL ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ELIZABETH
Last Name:BILLMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:ELIZABETH
Other - Last Name:BILLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:2030 STETSON PLACE CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-6736
Mailing Address - Country:US
Mailing Address - Phone:956-878-5719
Mailing Address - Fax:
Practice Address - Street 1:5500 AVENUE N
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5652
Practice Address - Country:US
Practice Address - Phone:281-238-0852
Practice Address - Fax:281-238-0865
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX554431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1922736586Medicaid