Chrystal Care

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

CHRYSTAL CARE

Practice address

3206 Stratford Cir
Morrow, GA 30260-8111

Phone

(929) 360-3857

NPI assigned

Sep 8, 2020

Last updated

Sep 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nijay Reddick

Title

Ceo

Phone

(929) 360-3857

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599523200000",
    "number": "1306451265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 STRATFORD CIR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302608111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 STRATFORD CIR",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302608111",
            "telephone_number": "929-360-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "REDDICK",
        "authorized_official_first_name": "NIJAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "929-360-3857"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashunda Carroll, CNA
• Centerwell Senior Primary Care Ga PC (CenterWell Senior Primary Care-Morrow)
• Cheng Chen, OD
• Peter Qiang Chen, O.D.
• Child, Youth, Adolescents, and Families
• Quoc T Chu, DC
• City of Morrow (Morrow Fire Department)
• Janeen Clark
• Jelunder A Woodard Clark, MD
• Michael Ahart Clark, LMT

• Adolescent and Children Mental Health Clinic/Center in Morrow, GA
• Providers in Morrow, GA by specialty
• Adolescent and Children Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.