Crystal Dawn Lane, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11029121 Issued in FL

Practice address

12811 Kenwood LN Ste 202
Fort Myers, FL 33907-5646

Phone

(239) 537-9646

Fax

(239) 236-0866

NPI assigned

May 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Therapy Treatment Team LLCGroup PAC ID 0446594451, 22 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.1 of 100Reported as group

Quality

82.5

Promoting interoperability

100

Improvement activities

40

Cost

81.16

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Therapy Treatment Team LLC

  • Mental Health Counselor
  • Fort Myers, FL
  • NPI 1053858316
  Medicare reassignment Care Compare group NPD
• Honour Brite LLC

  • Multi-Specialty Clinic/Center
  • Springfield, MO
  • NPI 1548760820
  Medicare reassignment
• Therapy Treatment Team LLC

  • Mental Health Counselor
  • Naples, FL
  • NPI 1932843588
  NPD
• Eustasis Foundation, Inc

  • Voluntary or Charitable Agency
  • Springfield, MO
  • NPI 1386257780
  NPD (past)

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1811633845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6252 S PHILMAR DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047904",
            "telephone_number": "417-350-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075646",
            "telephone_number": "239-537-9646",
            "fax_number": "239-236-0866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2345 Stanford Ct Ste 602",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341124841",
            "country_code": "US",
            "telephone_number": "239-537-9646",
            "fax_number": "239-236-0866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANE",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11029121",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "220223",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2022017504",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120758800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420109430",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284170758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lana Perkins RN BS DC PA
• Kimberly Marie Land, MSW
• Jesse Landis, LCSW
• Landmark Recovery of Florida LLC
• Lane Pediatrics PA
• Richard J Lane, MD
• Tisha Jane Lane, MS, LMHC
• Martha Tania Lange
• Carolyn F Langford, D.O.
• Casey Ray Langford, APRN

• Psychiatric/Mental Health Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.