Active NPI
Crystal Evon Daniels, LPCA
- Professional Counselor
- Mount Olive, NC
National Provider Identifier
1801239751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 9027
- Practice address
- 110 SW Center St
Mount Olive, NC 28365-2124 - Phone
- (919) 635-3344
- Fax
- (919) 635-3388
- NPI assigned
- Apr 10, 2013
- 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 | 9027 | NC | Primary |
Addresses
Primary practice location
110 SW Center St
Mount Olive, NC 28365-2124
Mailing address
1208 Judy PL
Goldsboro, NC 27530-6678
Phone (919) 581-9939
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9027 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548115200000",
"number": "1801239751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1208 JUDY PL",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275306678",
"telephone_number": "919-581-9939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 SW CENTER ST",
"city": "MOUNT OLIVE",
"state": "NC",
"postal_code": "283652124",
"telephone_number": "919-635-3344",
"fax_number": "919-635-3388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "CRYSTAL",
"middle_name": "EVON",
"name_prefix": "Ms.",
"credential": "LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-10",
"last_updated": "2019-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "9027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Olive, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.