Individual provider Active NPI

Crystal Hayse Edwards, NHC, LMT, NTS, LMHC

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1336304278
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CTB-2023-0078 Issued in NM
Practice address
5603 Essex Dr NW
Albuquerque, NM 87114-4719
Phone
(505) 896-0539
NPI assigned
Jul 21, 2008
Last updated
Jan 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CTB-2023-0078 NM Primary
Massage Therapist 225700000X 5546 NM

Addresses

Primary practice location

5603 Essex Dr NW
Albuquerque, NM 87114-4719

Mailing address

5603 Essex Dr NW
Albuquerque, NM 87114-4719
Phone (505) 896-0539

Other practice location 1

7850 Jefferson St NE Ste 300
Albuquerque, NM 87109-4314
Phone (505) 884-1114

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CTB-2023-0078NMMDMental Health Counselor
5546NMMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1336304278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 ESSEX DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144719",
            "telephone_number": "505-896-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 ESSEX DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144719",
            "telephone_number": "505-896-0539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7850 Jefferson St NE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871094314",
            "country_code": "US",
            "telephone_number": "505-884-1114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CRYSTAL",
        "middle_name": "HAYSE",
        "name_prefix": "Ms.",
        "credential": "NHC, LMT, NTS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CTB-2023-0078",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "5546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.