Crystal Marie Witt

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LISAC-15094 Issued in AZ

Practice address

7435 E Main St
Mesa, AZ 85207-8337

Phone

(480) 590-5293

Fax

(480) 564-1060

NPI assigned

Jun 7, 2019

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 identifiers 1

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.

• Brighter Heights Arizona, LLC Dba Hualapai Mountain

  • Mental Illness Community Based Residential Treatment Facility
  • Kingman, AZ
  • NPI 1770676439
  NPD (past)

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1588223184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 S SILVERADO ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852960924",
            "telephone_number": "602-492-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7435 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852078337",
            "telephone_number": "480-590-5293",
            "fax_number": "480-564-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LISAC-15094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISAC",
            "identifier": "LISAC-15094",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kandra Rae Wiseman, MA BCBA BHP
• Liane Wisman, NUTRITION COACH
• Michael Wisness, PHARM.D.
• Katie Witchley
• Ralph C Witmer III, PHARM.D.
• Erich Wittmer, PA, SA-C
• Emily N Keeble Witwer, P.T.
• Wize Healthcare LLC
• WM Ferrara General Contractor LLC
• Timothy T Woehl, M.D.

• Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.