Healthcare Provider Details

I. General information

NPI: 1902789357
Provider Name (Legal Business Name): CRYSTAL JEANETTE ROLON APONTE PSYCHOLOGIST AND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 BARNACLE CT SW
BOLLING AFB DC
20032-7401
US

IV. Provider business mailing address

23 BARNACLE CT SW
BOLLING AFB DC
20032-7401
US

V. Phone/Fax

Practice location:
  • Phone: 757-372-2381
  • Fax:
Mailing address:
  • Phone: 757-372-2381
  • Fax: 757-372-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7257
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10380
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: