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NPI Code Detail

MEDICARE: CARISSA LYNN CRUMP LPC

MEDICARE:   CARISSA LYNN CRUMP  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2101YP2500XProfessional Counselor94809TX

General Provider Information

NPI Number : 1053533281
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARISSA LYNN CRUMP LPC
Provider Business Mailing Address
First Line : 230 W MAPLE AVE
Second Line :
City : ENID
State : OK
Zip : 73701-4012
Country : US
Telephone Number : 580-242-5544
Fax Number :
Provider Business Practice Location Address
First Line : 230 W MAPLE AVE
Second Line :
City : ENID
State : OK
Zip : 73701-4012
Country : US
Telephone Number : 580-242-5544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 06/03/2026

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Directions to “ CARISSA LYNN CRUMP LPC” Practice Location

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