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General NPI Number Information
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NPI Number | 1548724404
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Entity Type | Individual
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Provider Name | CRYSTAL ALEXIA JEFFREY LCDC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 6201 BONHOMME RD STE 174N
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City | HOUSTON
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State | TX
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Zip | 77036-4367
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Country | US
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Telephone | 832-864-3347
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Fax | 833-241-7558
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Provider Business Mailing Address
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Address Line | 16714 SIDONIE DR
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City | HOUSTON
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State | TX
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Zip | 77053-2562
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Country | US
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Telephone | 832-721-3005
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13042
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 13042
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | TX
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