Provider Demographics
NPI:1982225025
Name:FORCE, CRYSTAL L (LPC)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:L
Last Name:FORCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WESTINGHOUSE RD APT 416
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-2364
Mailing Address - Country:US
Mailing Address - Phone:737-215-0373
Mailing Address - Fax:
Practice Address - Street 1:1400 WESTINGHOUSE RD APT 416
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-2364
Practice Address - Country:US
Practice Address - Phone:737-215-0373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional