Provider Demographics
NPI:1114788700
Name:OEHLERS, CRYSTAL ALANE GOODWIN (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:ALANE GOODWIN
Last Name:OEHLERS
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:ALANE
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 PARTRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-5118
Mailing Address - Country:US
Mailing Address - Phone:423-948-2618
Mailing Address - Fax:
Practice Address - Street 1:142 OLD TOWN BLVD N STE 200
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:TX
Practice Address - Zip Code:76226-3990
Practice Address - Country:US
Practice Address - Phone:940-294-7061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional