Crystal Joy Micken, LPC, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

961 Hall St
Bainbridge, GA 39819-4645

Phone

(229) 726-4714

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Thrive365, a Counseling Agency

  • Counselor
  • Bainbridge, GA
  • NPI 1245816750
  NPD Authorized official
• Serendipity Counseling & Consulting Agency

  • Professional Counselor
  • Bainbridge, GA
  • NPI 1487214052

  Professional

  NPD (past) Authorized official

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1770059313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "961 HALL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194645",
            "telephone_number": "229-726-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "961 HALL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194645",
            "telephone_number": "229-726-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKEN",
        "first_name": "CRYSTAL",
        "middle_name": "JOY",
        "credential": "LPC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Maxwell, LPC
• Bethany Breckenridge McElyea, LPC
• Amanda McNease, SLP
• Jon Mallory McRae Sr., DDS
• Jon Mallory McRae Jr., M.D.
• Milestones Pediatric Therapy, LLC
• Emilee Poppell Miller
• Gordon Chason Miller, M.D.
• Hannah Bius Miller, FNP-BC
• Rebekah Lynn Mills, LCSW

• All providers in Bainbridge, GA
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.