Provider Demographics
NPI:1932930096
Name:CRYSTAL SKY COUNSELING & CONSULTING, PLLC
Entity type:Organization
Organization Name:CRYSTAL SKY COUNSELING & CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, NCC
Authorized Official - Phone:910-527-2102
Mailing Address - Street 1:195 COOPER CREEK DR STE 101
Mailing Address - Street 2:118
Mailing Address - City:MOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27028-5968
Mailing Address - Country:US
Mailing Address - Phone:910-527-2102
Mailing Address - Fax:704-637-5507
Practice Address - Street 1:1414 DEVONMERE PL
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-9100
Practice Address - Country:US
Practice Address - Phone:910-527-2102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)