Crystal Amber Lynn Amick

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT107398 Issued in CA

Practice address

16519 Victor St Ste 421
Victorville, CA 92395-3935

Phone

(442) 242-4325

NPI assigned

Apr 24, 2014

Last updated

Sep 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nspiring Change- Marriage and Family Therapy Inc

  dba Nspiring Change

  • Marriage & Family Therapist
  • Victorville, CA
  • NPI 1184240459
  NPD Authorized official

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1891115184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13083 HILCORTE LN",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923943704",
            "telephone_number": "760-646-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16519 VICTOR ST STE 421",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953935",
            "telephone_number": "442-242-4325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17800 US Highway 18",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923071221",
            "country_code": "US",
            "telephone_number": "760-955-3682",
            "fax_number": "760-242-1425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMICK",
        "first_name": "CRYSTAL",
        "middle_name": "AMBER LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT107398",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.