Provider Demographics
NPI:1770344897
Name:FEATHERSTON, CRYSTAL NACHEA (LPC)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:NACHEA
Last Name:FEATHERSTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:NACHEA
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:823 MISSION AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7514
Mailing Address - Country:US
Mailing Address - Phone:757-576-7636
Mailing Address - Fax:
Practice Address - Street 1:700 MONTICELLO AVE STE 350
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2529
Practice Address - Country:US
Practice Address - Phone:757-937-9915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013219101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional