Provider Demographics
NPI:1104077122
Name:HAMMOND-MORROW, CRYSTAL (ED S, NCC, LPC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:HAMMOND-MORROW
Suffix:
Gender:F
Credentials:ED S, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W 404TH RD
Mailing Address - Street 2:
Mailing Address - City:BERTRAND
Mailing Address - State:MO
Mailing Address - Zip Code:63823-9182
Mailing Address - Country:US
Mailing Address - Phone:573-380-4545
Mailing Address - Fax:
Practice Address - Street 1:3301 W 404TH RD
Practice Address - Street 2:
Practice Address - City:BERTRAND
Practice Address - State:MO
Practice Address - Zip Code:63823-9182
Practice Address - Country:US
Practice Address - Phone:573-380-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007001743101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor