Organization Active NPI

Crystal Manjarrez PLLC

  • Mental Health Counselor
  • Berwyn, IL
National Provider Identifier
1962383794
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CRYSTAL MANJARREZ PLLC
Practice address
2504 Lombard Ave
Berwyn, IL 60402-2615
Phone
(708) 232-6076
NPI assigned
Sep 9, 2025
Last updated
Sep 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Crystal ManjarrezNPI 1811619943
Title
Owner
Phone
(708) 717-4206

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

2504 Lombard Ave
Berwyn, IL 60402-2615

Mailing address

680 N Lake Shore Dr Ste 110-2163
Chicago, IL 60611-4546

National Provider Directory

National Provider Directory

Locations

680 N Lake Shore Dr
Ste 1102163
Chicago, IL 60611

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1962383794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 110-2163",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 LOMBARD AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022615",
            "telephone_number": "708-232-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL MANJARREZ PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "MANJARREZ",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-717-4206"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.