Healthcare Provider Details

I. General information

NPI: 1609291988
Provider Name (Legal Business Name): CRYSTY A HUFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 01/15/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 MOTIF BLVD
BROWNSBURG IN
46112-1017
US

IV. Provider business mailing address

39 MOTIF BLVD
BROWNSBURG IN
46112-1017
US

V. Phone/Fax

Practice location:
  • Phone: 317-306-1837
  • Fax:
Mailing address:
  • Phone: 317-306-1837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34005814A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: