MEDICARE: MRS. MICHELLE RUTH CRYE 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
1	101YM0800X	Mental Health Counselor	14690	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093782930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE RUTH CRYE LPC

Provider Business Mailing Address
First Line	:	506 RICHARDSON ST
Second Line	:
City	:	ATHENS
State	:	TX
Zip	:	75751-3430
Country	:	US
Telephone Number	:	903-677-4800
Fax Number	:	903-677-4803

Provider Business Practice Location Address
First Line	:	506 RICHARDSON ST
Second Line	:
City	:	ATHENS
State	:	TX
Zip	:	75751-3430
Country	:	US
Telephone Number	:	903-677-4800
Fax Number	:	903-677-4803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	10/29/2009

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