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1710099031 NPI number — CRYSTAL LENA CHANG M.A., LPC

NPI Number: 1710099031
Health Care Provider/Practitioner: CRYSTAL LENA CHANG M.A., LPC

Information about “1710099031” NPI (CRYSTAL LENA CHANG M.A., LPC) exists in 1710099031 in HTML format HTML  |  1710099031 in plain Text format TXT  |  1710099031 in PDF (Portable Document Format) PDF  |  1710099031 in an XML format XML  formats.

NPI Number : 1710099031 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710099031",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CHANG",
    "FirstName": "CRYSTAL",
    "MiddleName": "LENA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.A., LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CHERRY",
    "OtherFirstName": "CRYSTAL",
    "OtherMiddleName": "LENA",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "M.A., LPC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4159 CANDLEWOOD CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WICHITA FALLS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76308-4451",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "940-636-4773",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4159 CANDLEWOOD CIR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WICHITA FALLS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76308-4451",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "940-636-4773",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/31/2006",
    "LastUpdateDate": "05/04/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": "31345",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": "62963",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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