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General NPI Number Information
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NPI Number | 1013785567
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Entity Type | Individual
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Provider Name | CRYSTAL CHOI LPC
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Gender | Female
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Dates
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Enumeration Date | 12/14/2023
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 770 N HALSTED ST STE 105
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City | CHICAGO
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State | IL
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Zip | 60642-7886
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Country | US
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Telephone | 312-219-3960
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 N BOSWORTH AVE UNIT 201
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City | CHICAGO
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State | IL
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Zip | 60642-3448
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Country | US
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Telephone | 201-655-9877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 178.019691
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License Number State | IL
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