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NPI 1205728060

NPI 1205728060 : CRYSTAL G SLUSS LPC : BIG STONE GAP, VA

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General NPI Number Information
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    NPI Number           |    1205728060
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    Entity Type          |    Individual 
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    Provider Name        |    CRYSTAL G SLUSS LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/16/2025
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    Last Update Date     |    01/21/2026
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Provider Practice Location Address
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    Address Line         |    43 CHAMPIONS AVE 
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    City                 |    BIG STONE GAP
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    State                |    VA
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    Zip                  |    24219-1105
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    Country              |    US
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    Telephone            |    276-523-0682
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    Fax                  |    276-523-0684
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Provider Business Mailing Address
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    Address Line         |    1167 SPRATLIN PARK DR 
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    City                 |    GRAY
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    State                |    TN
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    Zip                  |    37615-6205
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    Country              |    US
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    Telephone            |    423-467-3600
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    Fax                  |    423-467-3644
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    0701015077
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    License Number State |    VA
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