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General NPI Number Information
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NPI Number | 1861346686
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Entity Type | Individual
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Provider Name | CRYSTAL REINES LPC-IT
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Gender | Female
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 2725 MALL DR STE 7
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6835
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Country | US
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Telephone | 715-895-7115
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 W CLAIREMONT AVE STE 6
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6191
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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 |
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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 | 8608-226
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License Number State | WI
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