Crystal Hollenbeck, EDD, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11615 Issued in FL

Practice address

7345 W Sand Lake Rd Ste 303
Orlando, FL 32819-5205

Phone

(407) 408-6521

NPI assigned

Aug 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Crystal Hollenbeck Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1548936826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8015 INTERNATIONAL DR # 302",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328199312",
            "telephone_number": "407-408-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 W SAND LAKE RD STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195205",
            "telephone_number": "407-408-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBECK",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "EDD, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "11615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "HOLLENBECK",
            "prefix": "DR.",
            "credential": "EDD, LMHC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jessica Anzevino Holland, PA-C
• Kevan Michael Holland
• Matthew Holland, CRNA
• Michael Holland, LCSW
• Darren Scott Hollander, D.C.
• Laura E Hollenberger, ARNP
• Ashley Holley, RBT
• Joel Everett Holley, RBT
• Linda Jo Holley
• Tyler J Holley, MD, DDS

• Mental Health Counselor in Orlando, FL
• Providers in Orlando, 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 Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.