Provider Demographics
NPI:1740620434
Name:WALTER, CRYSTAL LYNETTE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:LYNETTE
Last Name:WALTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31478
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77231-1478
Mailing Address - Country:US
Mailing Address - Phone:832-439-7319
Mailing Address - Fax:
Practice Address - Street 1:6500 WEST LOOP S STE 200-C
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3535
Practice Address - Country:US
Practice Address - Phone:713-486-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53946104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker