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General NPI Number Information
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NPI Number | 1306626429
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Entity Type | Individual
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Provider Name | CRYSTAL ORTIZ MS, LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 4220 S MARYLAND PKWY BLDG A2
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City | LAS VEGAS
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State | NV
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Zip | 89119-7533
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Country | US
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Telephone | 415-424-4266
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Fax | 415-520-6633
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Provider Business Mailing Address
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Address Line | 100 N FEDERAL HWY APT 1121
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-1189
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Country | US
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Telephone | 516-643-1312
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CP5605-R
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License Number State | NV
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