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General NPI Number Information
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NPI Number | 1760361679
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Entity Type | Organization
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Legal Business Name | 9TH ACT LLC
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 17239 SHAVANO RNCH APT 1305
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1321
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Country | US
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Telephone | 702-907-4979
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Fax |
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Provider Business Mailing Address
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Address Line | 17239 SHAVANO RNCH APT 1305
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1321
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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 | CLINICAL PROFESSIONAL COUNSELOR-INT
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Name | CRYSTAL NARULA
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Credential | MS, CPC-I
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Telephone | 702-635-6085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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 |
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