Individual provider Active NPI

Crystal M Crumley, M.S.

  • Mental Health Counselor
  • Cleveland, TN
National Provider Identifier
1235352360
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4160 Ocoee St N Ste 8
Cleveland, TN 37312-4886
Phone
(888) 291-4357
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4160 Ocoee St N Ste 8
Cleveland, TN 37312-4886

Mailing address

4160 Ocoee St N Ste 8
Cleveland, TN 37312-4886
Phone (888) 291-4357

Other names 1

  • Crystal M Shire Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240126003261 TN Practitioner - Mental Health Counselor 3072966985 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Tennessee, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Centerstone of Tennessee, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Volunteer Behavioral Health Care System PastSince Aug 1, 2012 Accepting new patients

Locations

6110 Shallowford Rd
Ste B
Chattanooga, TN 37421
Phone (423) 499-1031

4160 Ocoee St N
Ste 8
Cleveland, TN 37312
Phone (423) 362-3111

1921 Ransom Pl
Nashville, TN 37217
Phone (615) 279-6700

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/vbhcs/r4/

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1235352360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 OCOEE ST N STE 8",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124886",
            "telephone_number": "888-291-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 OCOEE ST N STE 8",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124886",
            "telephone_number": "888-291-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMLEY",
        "first_name": "CRYSTAL",
        "middle_name": "M",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "SHIRE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.