Individual provider Active NPI

Crystal Dawn Fonville, LMFT

  • Marriage & Family Therapist
  • Livingston, TX
National Provider Identifier
1073397162
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
203893 Issued in TX
Practice address
1629 US Highway 190 E
Livingston, TX 77351-4487
Phone
(936) 259-2119
Fax
(936) 286-3106
NPI assigned
Aug 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 203893 TX Primary

Addresses

Primary practice location

1629 US Highway 190 E
Livingston, TX 77351-4487

Mailing address

1629 US Highway 190 E
Livingston, TX 77351-4487
Phone (936) 259-2119

Other practice location 1

7045 Highway 75 S
Huntsville, TX 77340-7281
Phone (936) 291-5800 ext. 5842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201000972 TX Practitioner - Marriage and Family Therapist 2264880251 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Serenity House Counseling, PLLCGroup PAC ID 3173973377, 11 clinicians

Practice addresses (Care Compare)

1629 US Hwy 190 E
Livingston, TX 77351-4487
Phone (936) 259-2119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Behavioral Healthcare CurrentSince Jan 1, 2024 Accepting new patients
Serenity House Counseling, PLLC CurrentSince Apr 8, 2025 Accepting new patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Dec 31, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

233 Sgt Ed Holcomb Blvd S
Conroe, TX 77304
Phone (936) 521-6151

706 Old Montgomery Rd
Conroe, TX 77301
Phone (936) 538-1102

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

7045 Highway 75 S
Huntsville, TX 77340
Phone (936) 281-5800

3748 US Highway 59 N
Ste A
Livingston, TX 77352
Phone (936) 259-2119

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1073397162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 US HIGHWAY 190 E",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514487",
            "telephone_number": "936-259-2119",
            "fax_number": "936-286-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 US HIGHWAY 190 E",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773514487",
            "telephone_number": "936-259-2119",
            "fax_number": "936-286-3106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7045 Highway 75 S",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "TX",
            "postal_code": "773407281",
            "country_code": "US",
            "telephone_number": "936-291-5800 x5842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FONVILLE",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "203893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

Verify at the official NPI Registry.