Healthcare Provider Details

I. General information

NPI: 1134752454
Provider Name (Legal Business Name): CRYSTAL ELIZABETH HOBAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 03/26/2025
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 GLEN STREET SUITE 24
GLEN FALLS NY
12801
US

IV. Provider business mailing address

300 GREAT OAKS BLVD SUITE 300
ALBANY NY
12203
US

V. Phone/Fax

Practice location:
  • Phone: 518-223-9291
  • Fax:
Mailing address:
  • Phone: 315-944-0525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001641
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: