Active NPI
Andrea L Crumrine, LPC
- Professional Counselor
- Garland, TX
National Provider Identifier
1730199191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 17161
- Practice address
- 705 W Avenue B Ste 306
Garland, TX 75040-6240 - Phone
- (972) 571-4468
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 17161 | TX | Primary |
Addresses
Primary practice location
705 W Avenue B Ste 306
Garland, TX 75040-6240
Mailing address
PO Box 1714
Rockwall, TX 75087-1714
Phone (972) 571-4468
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144637902 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 2, 2024 through Apr 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17161 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322611200000",
"number": "1730199191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1714",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750871714",
"telephone_number": "972-571-4468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 W AVENUE B STE 306",
"city": "GARLAND",
"state": "TX",
"postal_code": "750406240",
"telephone_number": "972-571-4468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUMRINE",
"first_name": "ANDREA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2011-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "17161",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144637902",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.