Provider Demographics
NPI:1245962828
Name:WILLIAMS, CRYSTAL D'SHAY (LPC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:D'SHAY
Last Name:WILLIAMS
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 1:4011 S COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4058
Mailing Address - Country:US
Mailing Address - Phone:913-710-6353
Mailing Address - Fax:
Practice Address - Street 1:601 N MUR LEN RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5431
Practice Address - Country:US
Practice Address - Phone:913-735-9750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04053101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional