Provider Demographics
NPI:1124752449
Name:DAVIS-YEBOAH, CRYSTAL LYNN (LMHC)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:LYNN
Last Name:DAVIS-YEBOAH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 MERLE HAY RD STE 227
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1312
Mailing Address - Country:US
Mailing Address - Phone:515-669-8111
Mailing Address - Fax:515-462-0633
Practice Address - Street 1:3839 MERLE HAY RD STE 227
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1312
Practice Address - Country:US
Practice Address - Phone:515-669-8111
Practice Address - Fax:515-462-0633
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111768101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty