Kristin Crumbley, LMHC, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

17903 Issued in FL

Practice address

240 N Frederick Ave
Daytona Beach, FL 32114

Phone

(386) 675-0118

NPI assigned

Jun 16, 2020

Sex

Female

Sole proprietor

Yes

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.

• Brave Health Inc.

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821588674

  FL

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  FL, Mental Health

  Medicare reassignment NPD
• Florida United Methodist Children'S Home Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Enterprise, FL
  • NPI 1225006059
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 16, 2020.

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1164047106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N FREDERICK AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321143400",
            "telephone_number": "386-675-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 N FREDERICK AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-675-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMBLEY",
        "first_name": "KRISTIN",
        "credential": "LMHC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "17903",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "3816",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wendy_seavers@outreachinc.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "240 N Frederick Ave",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321143400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crouch & Dunn MD LLC
• Eugene Marion Crouch, M.D.
• Julie Crouch
• Sandra E Crow, LPN
• Desirae Anne Crowell
• Natalia Cruz Alvarez, MD
• Roberto Antonio Cruz Barahona, M.D.
• Grace Cruz, MD
• Kim B Csabi, ATC, LAT
• Maritza Cubero

• All providers in Daytona Beach, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.