Active NPI
Crystal Duane Johnson, M.S.
- Counselor
- Tyler, TX
National Provider Identifier
1942571153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 9187
- Practice address
- 401 E Front Street
Suite 139
Tyler, TX 75701-1608 - Phone
- (903) 570-8513
- Fax
- (903) 533-0673
- NPI assigned
- Jan 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 9187 | TX | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0831-0991 | TX | |
| Marriage & Family Therapist | 106H00000X | 88 | TX |
Addresses
Primary practice location
401 E Front Street
Suite 139
Tyler, TX 75701-1608
Mailing address
814 S. Broadway Ave.
Tyler, TX 75701
Phone (903) 570-8513
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9187 | TX | MD | Counselor |
| 0831-0991 | TX | MD | Addiction (Substance Use Disorder) Counselor |
| 88 | TX | MD | Primary Podiatric Medicine Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326931200000",
"number": "1942571153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "814 S. BROADWAY AVE.",
"city": "TYLER",
"state": "TX",
"postal_code": "75701",
"telephone_number": "903-570-8513",
"fax_number": "903-533-0673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E FRONT STREET",
"address_2": "SUITE 139",
"city": "TYLER",
"state": "TX",
"postal_code": "757011608",
"telephone_number": "903-570-8513",
"fax_number": "903-533-0673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CRYSTAL",
"middle_name": "DUANE",
"name_prefix": "Ms.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-19",
"last_updated": "2012-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "9187",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "0831-0991",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "88",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.