MEDICARE: CRYSTAL R CURRIE LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	13659	NC

General Provider Information

NPI Number	:	1366085094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL R CURRIE LCMHC

Provider Business Mailing Address
First Line	:	3515 DAVID COX RD UNIT 481321
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2537
Country	:	US
Telephone Number	:	704-336-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 DAVID COX RD UNIT 481321
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2537
Country	:	US
Telephone Number	:	704-336-0366
Fax Number	:	803-608-0987

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2019
Last Update Date	:	10/13/2025

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