Crystal N. Broughton

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

013641 Issued in GA

Practice address

1775 Parker Rd SE Ste 210
Conyers, GA 30094-6654

Phone

(470) 967-8663

Fax

(678) 218-4253

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1013575877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 GREEN ST SE UNIT 1823",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125556",
            "telephone_number": "470-967-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 PARKER RD SE STE 210",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946654",
            "telephone_number": "470-967-8663",
            "fax_number": "678-218-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "CRYSTAL",
        "middle_name": "N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "013641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela L. Bright, N.P.
• Bristol Village Management LLC
• Brooks and Giles DC, LLC
• Janelle H Brooks, PHD
• Sarah Elizabeth Brooks, PT
• Shanelle Brown Best
• Asandra Brown
• Ayana C Brown
• Donna-Marie Erika Brown, M.D.
• Joshua Michael Brown, DPT, PT

• Professional Counselor in Conyers, GA
• Providers in Conyers, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.