Individual provider Active NPI

Crystal Martin, MS

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1821799529
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
525 S 4TH St Ste 471
Philadelphia, PA 19147-1582
Phone
(267) 861-3685
NPI assigned
Mar 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PA Primary

Addresses

Primary practice location

525 S 4TH St Ste 471
Philadelphia, PA 19147-1582

Mailing address

PO Box 31
Ernest, PA 15739-0031
Phone (814) 541-0622

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Equilibria Mental Health Services CurrentSince Jan 1, 2022 Accepting new patients
Equilibria Psychological and Consultation Services, LLC CurrentSince Jun 1, 2020 Accepting new patients

Locations

525 S 4th St
Ste 471
Philadelphia, PA 19147
Phone (215) 861-3685

630 Fitzwatertown Rd
Ste A1
Willow Grove, PA 19090
Phone (215) 658-4553

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.

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1821799529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31",
            "city": "ERNEST",
            "state": "PA",
            "postal_code": "157390031",
            "telephone_number": "814-541-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S 4TH ST STE 471",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471582",
            "telephone_number": "267-861-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CRYSTAL",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.