Crystal Nicky Treadway, LMHC,NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 12436 Issued in FL

Practice address

201 SW Port St Lucie Blvd Ste 1
Port Saint Lucie, FL 34984-5001

Phone

(561) 315-4841

NPI assigned

Aug 13, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Crystal Morris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Anchors Aweigh Counseling

  • Adult Mental Health Clinic/Center
  • Port St Lucie, FL
  • NPI 1427672757
  NPD

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442880000000",
    "number": "1497060404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 SW JAMESPORT DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349534377",
            "telephone_number": "561-315-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SW PORT ST LUCIE BLVD STE 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349845001",
            "telephone_number": "561-315-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWAY",
        "first_name": "CRYSTAL",
        "middle_name": "NICKY",
        "name_prefix": "Ms.",
        "credential": "LMHC,NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-13",
        "last_updated": "2015-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 12436",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "MORRIS",
            "credential": "LMHC, NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; 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.