=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003385725
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRYSTAL MARIE LEE DANCY MSW, LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/26/2018
-----------------------------------------------------
Last Update Date | 01/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | USAG HOHENFELS ARMY HEALTH CLINIC
-----------------------------------------------------
City | HOHENFELS
-----------------------------------------------------
State | GERMANY
-----------------------------------------------------
Zip | 09173
-----------------------------------------------------
Country | DE
-----------------------------------------------------
Telephone | 314-590-3354
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | CMR 414 BOX 1463
-----------------------------------------------------
City | APO
-----------------------------------------------------
State | AE
-----------------------------------------------------
Zip | 09173-1015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-394-4041
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | C011536
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------