Active NPI
Crystal Gholston
- Mental Health Counselor
- Tunica, MS
National Provider Identifier
1750178794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1459 Main St
Tunica, MS 38676 - Phone
- (662) 363-3222
- Fax
- (662) 363-4749
- NPI assigned
- Apr 23, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MS | Primary |
Addresses
Primary practice location
1459 Main St
Tunica, MS 38676
Mailing address
831 Amanda CV
Hernando, MS 38632-1333
Phone (662) 299-4677
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Region VI Community Mental Health Commission | Past | Accepting new patients | |
| Region One Mental Health Center | Past | Accepting new patients |
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.
-
- Public Health or Welfare Agency
- Clarksdale, MS
- NPI 1669499687
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Greenwood, MS
- NPI 1154433233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745366400000",
"number": "1750178794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "831 AMANDA CV",
"city": "HERNANDO",
"state": "MS",
"postal_code": "386321333",
"telephone_number": "662-299-4677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1459 MAIN ST",
"city": "TUNICA",
"state": "MS",
"postal_code": "38676",
"telephone_number": "662-363-3222",
"fax_number": "662-363-4749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHOLSTON",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-23",
"last_updated": "2025-04-23",
"certification_date": "2025-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tunica, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.