Active NPI
Crystal M Holmes, LCMHC
- Professional Counselor
- Hurlburt Field, FL
National Provider Identifier
1740758887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 23443
- Practice address
- 344 Tully St
Hurlburt Field, FL 32544-5810 - Phone
- (850) 884-6420
- NPI assigned
- Nov 7, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14383 | NC | |
| Professional Counselor | 101YP2500X | 14383 | NC | |
| Professional Counselor | 101YP2500X | 23443 | FL | Primary |
Addresses
Primary practice location
344 Tully St
Hurlburt Field, FL 32544-5810
Mailing address
344 Tully St
Hurlburt Field, FL 32544-5810
Phone (850) 884-6420
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 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23443 | FL | MD | Professional Counselor |
| 14383 | NC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| True Joy Counseling and Consulting, PLLC | Mental Health | Current | Accepting new patients |
| Responder Support Services | Mental Health | Past | Accepting new patients |
Locations
1041 John Sims Pkwy E
Niceville, FL 32578
Phone (850) 389-8489
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Niceville, FL
- NPI 1487020368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1740758887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 TULLY ST",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325445810",
"telephone_number": "850-884-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "344 TULLY ST",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325445810",
"telephone_number": "850-884-6420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "CRYSTAL",
"middle_name": "M",
"credential": "LCMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-07",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "14383",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "14383",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "FL",
"license": "23443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurlburt Field, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.