Crystal Lynn Bollman
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mount Vernon, IL
NPI 1891205779 · NPPES record last updated Oct 5, 2017
Key facts
- NPI
- 1891205779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 16338 N Il Highway 37
Mount Vernon, IL 62864-8178 - Phone
- (618) 242-1546
- Fax
- (618) 242-6392
- NPI assigned
- Oct 5, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | IL | Yes |
Addresses
Primary practice location
16338 N Il Highway 37
Mount Vernon, IL 62864-8178
Mailing address
16338 N Il Highway 37
Mount Vernon, IL 62864-8178
Phone (618) 242-1546
Other providers in Mount Vernon, IL
- Michele L Boester
- Brittney Boldt
- Faye Boldwyn-Stephens
- Shanda Lynette Boling-Taylor
- Rhian Boling
- Christie Bond
- Cynthia Booher
- Borowiak Iga Foodliner Inc
- Christopher Bourget
- Bowman Chiropractic
All providers in Mount Vernon, IL · Addiction (Substance Use Disorder) Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.