Active NPI
Crystal Lea Corbin, LPC #3452
- Counselor
- Bossier City, LA
National Provider Identifier
1063687036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- #3452
- Practice address
- 2285 Benton Rd
Suite D-201, Office 1
Bossier City, LA 71111-7933 - Phone
- (318) 747-4070
- Fax
- (318) 742-4162
- NPI assigned
- Apr 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | #3452 | LA | Primary |
Addresses
Primary practice location
2285 Benton Rd
Suite D-201, Office 1
Bossier City, LA 71111-7933
Mailing address
PO Box 1496
Benton, LA 71006-1496
Phone (318) 747-4070
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #3452 | LA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Courtney Miller, LPC North Bossier Counseling Corp | Counselor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Counselor
- Benton, LA
- NPI 1417540170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209427200000",
"number": "1063687036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1496",
"city": "BENTON",
"state": "LA",
"postal_code": "710061496",
"telephone_number": "318-747-4070",
"fax_number": "318-742-4162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2285 BENTON RD",
"address_2": "SUITE D-201, OFFICE 1",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711117933",
"telephone_number": "318-747-4070",
"fax_number": "318-742-4162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORBIN",
"first_name": "CRYSTAL",
"middle_name": "LEA",
"credential": "LPC #3452",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2008-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "LA",
"license": "#3452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.