Active NPI
Crystal Lena Chang, M.A., LPC
- Professional Counselor
- Wichita Falls, TX
National Provider Identifier
1710099031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 62963
- Practice address
- 4159 Candlewood Cir
Wichita Falls, TX 76308-4451 - Phone
- (940) 636-4773
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 31345 | TX | |
| Professional Counselor | 101YP2500X | 62963 | TX | Primary |
Addresses
Primary practice location
4159 Candlewood Cir
Wichita Falls, TX 76308-4451
Mailing address
4159 Candlewood Cir
Wichita Falls, TX 76308-4451
Phone (940) 636-4773
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00T22Y | Other | TX | BCBS # |
| 111408401 | Medicaid | TX | |
| 111408402 | Medicaid | TX |
Other names 1
- Miss Crystal Lena Cherry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62963 | TX | MD | Social Worker |
| 31345 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1710099031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4159 CANDLEWOOD CIR",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763084451",
"telephone_number": "940-636-4773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4159 CANDLEWOOD CIR",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763084451",
"telephone_number": "940-636-4773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "CRYSTAL",
"middle_name": "LENA",
"name_prefix": "Mrs.",
"credential": "M.A., LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TX",
"license": "31345",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "62963",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS #",
"identifier": "00T22Y",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111408401",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111408402",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CRYSTAL",
"last_name": "CHERRY",
"middle_name": "LENA",
"prefix": "MISS",
"credential": "M.A., LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.