Healthcare Provider Details

I. General information

NPI: 1164064978
Provider Name (Legal Business Name): CRYSTAL AERIN AMEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRYSTAL AERIN DEWEEVER LPC

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 GORDON SMITH DR.
MOBILE AL
36617
US

IV. Provider business mailing address

9088 DIAMANTE BLVD
DAPHNE AL
36526-0615
US

V. Phone/Fax

Practice location:
  • Phone: 251-450-4315
  • Fax:
Mailing address:
  • Phone: 251-525-3713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4160
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: