Individual provider Active NPI

Chrystal Brassfield, MS

  • Mental Health Counselor
  • Vinita, OK
National Provider Identifier
1043592132
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
405 E Excelsior Ave
Vinita, OK 74301-4226
Phone
(918) 256-6476
Fax
(918) 256-3628
NPI assigned
Sep 14, 2011
Last updated
Jan 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

405 E Excelsior Ave
Vinita, OK 74301-4226

Mailing address

405 E Excelsior Ave
Vinita, OK 74301-4226
Phone (918) 256-6476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Sydlyfe Counseling Services, LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3606 N Martin Luther King Jr Blvd
Tulsa, OK 74106
Phone (918) 728-8512

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1043592132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E EXCELSIOR AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014226",
            "telephone_number": "918-256-6476",
            "fax_number": "918-256-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E EXCELSIOR AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743014226",
            "telephone_number": "918-256-6476",
            "fax_number": "918-256-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSFIELD",
        "first_name": "CHRYSTAL",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinita, OK

Sources for this page

Verify at the official NPI Registry.