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General NPI Number Information
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NPI Number | 1477616878
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Entity Type | Individual
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Provider Name | CRYSTAL LEIGH MATTHEWS MSE
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1909 VICKI LN STE 105
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City | NORFOLK
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State | NE
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Zip | 68701-4542
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Country | US
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Telephone | 402-256-7883
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Fax | 402-226-6024
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Provider Business Mailing Address
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Address Line | 1904 N 17TH CIR
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City | NORFOLK
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State | NE
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Zip | 68701-2162
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Country | US
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Telephone | 402-640-2721
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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 | 3520
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8542
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License Number State | NE
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