Individual provider Active NPI

Crystal Thompson, LPC

  • Professional Counselor
  • Keller, TX
National Provider Identifier
1548017148
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
59996 Issued in TX
Practice address
620 Stoneglen Dr Ste B
Keller, TX 76248-3625
Phone
(817) 562-8800
NPI assigned
May 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 59996 TX Primary

Addresses

Primary practice location

620 Stoneglen Dr Ste B
Keller, TX 76248-3625

Mailing address

4637 Timken TRL
Fort Worth, TX 76137-6147
Phone (817) 300-5329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515001262 TX Practitioner - Mental Health Counselor 9032550512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Redefine LLCGroup PAC ID 4284071879, 7 clinicians

Practice addresses (Care Compare)

620 Stoneglen Dr
Suite B
Keller, TX 76248-3625
Phone (817) 562-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Redefine LLC CurrentSince May 1, 2024 Accepting new patients

Locations

620 Stoneglen Dr
Ste B
Keller, TX 76248
Phone (817) 562-8800

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1548017148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4637 TIMKEN TRL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761376147",
            "telephone_number": "817-300-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 STONEGLEN DR STE B",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483625",
            "telephone_number": "817-562-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CRYSTAL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "59996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.