Crystal Kittrell-Johnson, PHD, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701004619 Issued in VA

Practice address

3575 Bridge Rd Ste 8
# 201
Suffolk, VA 23435

Phone

(757) 632-7107

NPI assigned

Sep 18, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Canvas Counseling and Consulting LLC

  • Mental Health Counselor
  • Suffolk, VA
  • NPI 1790483055
  NPD Authorized official

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1770919029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD STE 8",
            "address_2": "#201",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435",
            "telephone_number": "757-632-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 BRIDGE RD STE 8",
            "address_2": "# 201",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435",
            "telephone_number": "757-632-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTRELL-JOHNSON",
        "first_name": "CRYSTAL",
        "credential": "PHD, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004619",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701004619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "0701004619",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda King
• Amy P King, NP
• Tabitha King, LMT
• Casey Harp Kirlin
• Myecha Kitchen, LCSW
• Audrey Catherine Klecka, FNP-C
• Sandra Klingmeyer Wiggins
• Tracy L Knaak, PA-C
• Richard D Knauft, M.D.
• Cheryl Knight

• Mental Health Counselor in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.