Individual provider Active NPI

Crystal G Marshall, APRN-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Westlake, OH
National Provider Identifier
1205709490
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-CNP0040071 Issued in OH
Practice address
24481 Detroit Rd Ste 201
Westlake, OH 44145-1557
Phone
(216) 650-7381
NPI assigned
Sep 25, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X APRN-CNP0040071 OH Primary

Addresses

Primary practice location

24481 Detroit Rd Ste 201
Westlake, OH 44145-1557

Mailing address

6545 Market Ave N Ste 100
Canton, OH 44721-2430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251110002139 OH Practitioner - Nurse Practitioner 2264922061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

24481 Detroit Ave
Suite 201
Westlake, OH 44145

24481 Detroit Rd
Suite 201
Westlake, OH 44145-1557

2906 Cormorant Rd
Delray Beach, FL 33444-3334

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-CNP0040071OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holding Space LLC Single Specialty CurrentSince Oct 1, 2025 Accepting new patients

Locations

8927 Brecksville Rd
Brecksville, OH 44141
Phone (440) 310-6361

24481 Detroit Rd
Ste 201
Westlake, OH 44145
Phone (440) 310-6361

Organizations & group practices 2

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": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1205709490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 MARKET AVE N STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447212430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24481 DETROIT RD STE 201",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451557",
            "telephone_number": "216-650-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "CRYSTAL",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN-CNP0040071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.