Healthcare Provider Details

I. General information

NPI: 1558283655
Provider Name (Legal Business Name): CRYSTAL LYNN DUNCAN LANE LMFT, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 BRIARWOOD DR
BLACKSBURG VA
24060-2663
US

IV. Provider business mailing address

1409 BRIARWOOD DR
BLACKSBURG VA
24060-2663
US

V. Phone/Fax

Practice location:
  • Phone: 217-294-0240
  • Fax:
Mailing address:
  • Phone: 217-294-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710103933
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717002439
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: