Provider Demographics
NPI:1326616715
Name:CRYSTALYN JASS KIRKPATRICK COUNSELING PLLC
Entity type:Organization
Organization Name:CRYSTALYN JASS KIRKPATRICK COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTALYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JASS KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MED, NCC, LPC
Authorized Official - Phone:512-967-6783
Mailing Address - Street 1:3801 N CAPITAL OF TX HWY STE E-240 PMB 1003
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1313
Mailing Address - Country:US
Mailing Address - Phone:512-967-6783
Mailing Address - Fax:512-886-7578
Practice Address - Street 1:3801 N CAPITAL OF TX HWY STE E-240 PMB 1003
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-1313
Practice Address - Country:US
Practice Address - Phone:512-967-6783
Practice Address - Fax:512-886-7578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health