Dr Crystal Malloy, PHD, LPC, MAC, CEAP is a medicare enrolled "Counselor - Professional" provider in Guyton, Georgia. Her current practice location is
174 Scholar Rd, Guyton, Georgia. You can reach out to her office (for appointments etc.) via phone at
(337) 396-5592.
Dr Crystal Malloy is licensed to practice in Georgia (license number LPC008241) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1679958771.
Healthcare Provider's Profile
| Full Name | Dr Crystal Malloy |
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| Gender | Female |
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| Speciality | Counselor - Professional |
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| Location | 174 Scholar Rd, Guyton, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1679958771
- Provider Enumeration Date: 07/30/2015
- Last Update Date: 11/26/2018
Medicare PECOS Information:
- PECOS PAC ID: 8022469360
- Enrollment ID: I20240110004725
Medical Identifiers
Medical identifiers for Dr Crystal Malloy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679958771 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | 6233 (Louisiana) | Secondary |
| 106H00000X | Marriage & Family Therapist | LPC08241 (Georgia) | Secondary |
| 221700000X | Art Therapist | LPC8241 (Georgia) | Secondary |
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | LPC008241 (Georgia) | Secondary |
| 225A00000X | Music Therapist | LC008241 (Georgia) | Secondary |
| 101YP2500X | Counselor - Professional | LPC008241 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Crystal Malloy allows following entities to bill medicare on her behalf.
| Entity Name | Diversity Health Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1326594714
PECOS PAC ID: 9638261910
Enrollment ID: O20110810000508 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Crystal Malloy is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Crystal Malloy, PHD, LPC, MAC, CEAP
174 Scholar Rd,
Guyton, GA 31312-6240
Ph: (337) 205-9357 | Dr Crystal Malloy, PHD, LPC, MAC, CEAP
174 Scholar Rd,
Guyton, GA 31312-6240
Ph: (337) 396-5592 |
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