Active NPI
Crystal Ann Church
- Professional Counselor
- Cumberland, MD
National Provider Identifier
1881122406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGP7406
- Practice address
- 200 Glenn St
Cumberland, MD 21502-2573 - Phone
- (240) 580-1919
- Fax
- (240) 362-7409
- NPI assigned
- May 26, 2017
- Last updated
- May 26, 2017
- Sex
- Female
- Sole proprietor
- No
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 | LGP7406 | MD | Primary |
Addresses
Primary practice location
200 Glenn St
Cumberland, MD 21502-2573
Mailing address
45 Mitchell St
Romney, WV 26757-6871
Phone (304) 822-6009
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 |
|---|---|---|---|
| LGP7406 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495756800000",
"number": "1881122406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 MITCHELL ST",
"city": "ROMNEY",
"state": "WV",
"postal_code": "267576871",
"telephone_number": "304-822-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 GLENN ST",
"city": "CUMBERLAND",
"state": "MD",
"postal_code": "215022573",
"telephone_number": "240-580-1919",
"fax_number": "240-362-7409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCH",
"first_name": "CRYSTAL",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-26",
"last_updated": "2017-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP7406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumberland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.