Provider Demographics
NPI:1932283835
Name:KIRSCHMAN, CRYSTAL MONIQUE (MA, LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MONIQUE
Last Name:KIRSCHMAN
Suffix:
Gender:F
Credentials:MA, LCPC, NCC
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:MONIQUE
Other - Last Name:CUARON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:802 GUMWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-7924
Mailing Address - Country:US
Mailing Address - Phone:575-749-2057
Mailing Address - Fax:
Practice Address - Street 1:600 CENTRAL AVENUE
Practice Address - Street 2:SUITE 407
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3143
Practice Address - Country:US
Practice Address - Phone:406-952-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0168341101YM0800X
MT12475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health