A Crystal Mind
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Cincinnati, OH
NPI 1467068262 · NPPES record last updated Jan 16, 2021
Key facts
- NPI
- 1467068262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- A CRYSTAL MIND
- Practice address
- 4015 Executive Park Dr Ste 310
Cincinnati, OH 45241-4015 - Phone
- (513) 923-6336
- Fax
- (562) 261-1296
- NPI assigned
- Sep 17, 2020
- Organization subpart
- No
Authorized official
- Name
- Crystal Farrell, MSN, CNP
- Title
- Owner
- Phone
- (513) 923-6336
National Provider Directory
Locations
4015 Executive Park Dr
Ste 310
Cincinnati, OH 45241
Phone (513) 923-6336
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | |||
| Assisted Living Facility (Mental Illness) | 3104A0625X | |||
| Mental Illness Intermediate Care Facility | 310500000X | |||
| Alzheimer Center (Dementia Center) | 311500000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
4015 Executive Park Dr Ste 310
Cincinnati, OH 45241-4015
Mailing address
PO Box 1441
West Chester, OH 45071-1441
Phone (513) 923-6336
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.