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General NPI Number Information
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NPI Number | 1437007945
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Entity Type | Organization
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Legal Business Name | CRYSTAL CLEAR COUNSELING, PLLC
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 1535 DATE DR
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City | TITUSVILLE
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State | FL
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Zip | 32780-3337
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Country | US
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Telephone | 321-641-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | ALEXANDRA RUETZ
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Credential | LMHC
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Telephone | 321-641-4810
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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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