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General NPI Number Information
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NPI Number | 1366319923
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Entity Type | Organization
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Legal Business Name | AMERICAN ASSOCIATION OF SOMATIC SEXOLOGISTS
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 11539 LIGHTNING WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3918
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Country | US
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Telephone | 808-954-0224
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 94932
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City | ATLANTA
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State | GA
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Zip | 30377-1932
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Country | US
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Telephone | 808-954-0224
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CRYSTAL AMINA PETERSON
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Credential | SSE, CS, SEP
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Telephone | 808-954-0224
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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