Provider Demographics
NPI:1992368062
Name:CAROLINE M. CRISOL, LMFT INC
Entity Type:Organization
Organization Name:CAROLINE M. CRISOL, LMFT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-233-5525
Mailing Address - Street 1:24405 CHESTNUT ST STE 205
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2852
Mailing Address - Country:US
Mailing Address - Phone:818-233-5525
Mailing Address - Fax:661-554-2172
Practice Address - Street 1:24405 CHESTNUT ST STE 205
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2852
Practice Address - Country:US
Practice Address - Phone:818-233-5525
Practice Address - Fax:661-554-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)