Provider Demographics
NPI:1306505870
Name:CRYSTAL HILLS COUNSELING AND CONSULTING SERVICES PLLC
Entity type:Organization
Organization Name:CRYSTAL HILLS COUNSELING AND CONSULTING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:CRONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-747-0170
Mailing Address - Street 1:3309 FIECHTNER DR S STE B
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2375
Mailing Address - Country:US
Mailing Address - Phone:701-747-0170
Mailing Address - Fax:
Practice Address - Street 1:3309 FIECHTNER DR S STE B
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2375
Practice Address - Country:US
Practice Address - Phone:701-747-0170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-13
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty