Active NPI
Crystal Ann Bostow Liddycoat, MA, LAC, LPC
- Mental Health Counselor
- West Fargo, ND
National Provider Identifier
1356581227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 621-12-15-08
- Practice address
- 726 13TH Ave E
West Fargo, ND 58078-3304 - Phone
- (971) 500-2661
- NPI assigned
- Mar 4, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1596 | ND | |
| Mental Health Counselor | 101YM0800X | CP6207-R | NV | |
| Mental Health Counselor | 101YM0800X | 621-12-15-08 | ND | Primary |
Addresses
Primary practice location
726 13TH Ave E
West Fargo, ND 58078-3304
Mailing address
2910 38TH Ave S
Fargo, ND 58104-7061
Phone (530) 799-0499
Other practice location 1
6258 14th St S
Fargo, ND 58104-7230
Phone (530) 799-0499
Other names 1
- Miss Crystal Ann Bostow
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP6207-R | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768262400000",
"number": "1356581227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 38TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581047061",
"telephone_number": "530-799-0499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 13TH AVE E",
"city": "WEST FARGO",
"state": "ND",
"postal_code": "580783304",
"telephone_number": "971-500-2661"
}
],
"practiceLocations": [
{
"address_1": "6258 14th St S",
"address_purpose": "LOCATION",
"city": "Fargo",
"state": "ND",
"postal_code": "581047230",
"country_code": "US",
"telephone_number": "530-799-0499",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIDDYCOAT",
"first_name": "CRYSTAL",
"middle_name": "ANN BOSTOW",
"name_prefix": "Mrs.",
"credential": "MA, LAC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-04",
"last_updated": "2026-01-13",
"certification_date": "2026-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ND",
"license": "1596",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CP6207-R",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ND",
"license": "621-12-15-08",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "BOSTOW",
"middle_name": "ANN",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in West Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.