Provider Demographics
NPI:1477616878
Name:MATTHEWS, CRYSTAL LEIGH (MSE)
Entity type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:LEIGH
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 N 17TH CIR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2162
Mailing Address - Country:US
Mailing Address - Phone:402-640-2721
Mailing Address - Fax:
Practice Address - Street 1:1909 VICKI LN STE 105
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4542
Practice Address - Country:US
Practice Address - Phone:402-256-7883
Practice Address - Fax:402-226-6024
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3520101YM0800X
NE8542101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health