Individual provider Active NPI

Crystal Odom

  • Counselor
  • Jasper, AL
National Provider Identifier
1083566426
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
ALC05672 Issued in AL
Practice address
211 Meadow Way
Jasper, AL 35504-8506
Phone
(205) 764-2917
NPI assigned
Feb 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X ALC05672 AL Primary

Addresses

Primary practice location

211 Meadow Way
Jasper, AL 35504-8506

Mailing address

211 Meadow Way
Jasper, AL 35504-8506
Phone (205) 764-2917

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

LicenseStateTypeSpecialty
ALC05672ALMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1083566426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MEADOW WAY",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355048506",
            "telephone_number": "205-764-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MEADOW WAY",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355048506",
            "telephone_number": "205-764-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "CRYSTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "ALC05672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; 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.