Chrystal Fullen Ms LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

71964 Issued in TX

Legal business name

CHRYSTAL FULLEN MS LPC

Practice address

4242 Woodcock Dr Ste 201
San Antonio, TX 78228-1325

Phone

(210) 481-8673

Fax

(210) 314-2480

NPI assigned

Feb 8, 2018

Organization subpart

No

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

Authorized official

Name

Chrystal Fullen, LPCNPI 1053768911

Title

Sole Member

Phone

(210) 410-3710

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chrystal Tarryn Fullen, PSYD

  • Clinical Neuropsychologist
  • Little Rock, AR
  • NPI 1053768911

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1952800658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4242 WOODCOCK DR STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281325",
            "telephone_number": "210-481-8673",
            "fax_number": "210-314-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 WOODCOCK DR STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281325",
            "telephone_number": "210-481-8673",
            "fax_number": "210-314-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSTAL FULLEN MS LPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "FULLEN",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "210-410-3710",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "71964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chronic Pain Resource Center of South Texas
• Chronic Wound Solutions of Texas LLC
• Chrysalis a. Heinkel, DDS, PLLC
• Chrysalis Counseling & Wellness, PLLC
• Minas Chrysopoulo, M.D.
• CHS Texas Medical, P.a.
• Edward Rickie Lim Chu, MD
• Erica Chu
• Hy Xuan Chu
• Lawrence Der Chang Chu

• Professional Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.