Crystal Lynn Favre, LPC007028, GEORGIA

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2404 Refuge Rd
Jasper, GA 30143-4946

Phone

(706) 692-7209

Fax

(706) 693-0144

NPI assigned

Oct 2, 2009

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

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Behavioral Kinetics

  • Professional Counselor
  • Kennesaw, GA
  • NPI 1730936840
  Medicare reassignment NPD

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1619202041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 ROCKY RIDGE PASS",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149751",
            "telephone_number": "404-786-2040",
            "fax_number": "770-345-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 REFUGE RD",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434946",
            "telephone_number": "706-692-7209",
            "fax_number": "706-693-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVRE",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "LPC007028, GEORGIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Deloach Everett, LCSW
• Molly Beth Faison, CCC-SLP
• Christopher David Farmer, MS, LPC, MAC, CPCS
• John Farr, M.D.
• Carlton Trent Faulk, MEDICAL DOCTOR
• First Mountain Medical, LLC
• Lisa Ann Flint, APRN
• Russell Austin Flint, MD
• Foot and Ankle Reconstruction of North Georgia PC
• Fortis Health, LLC

• Counselor in Jasper, GA
• Providers in Jasper, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.