| Crystal Counseling Pllc | |
|
116 Gallery Cir Ste 201 San Antonio TX 78258-3341 | |
| (210) 998-5591 | |
| (210) 579-1516 |
| Full Name | Crystal Counseling Pllc |
|---|---|
| Speciality | Case Management |
| Location | 116 Gallery Cir Ste 201, San Antonio, Texas |
| Authorized Official Name and Position | Lawrence C Mack (PRESIDENT) |
| Authorized Official Contact | 2109985591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Counseling Pllc 18756 Stone Oak Pkwy Suite 200 San Antonio TX 78258-4790 Ph: (210) 998-5591 | Crystal Counseling Pllc 116 Gallery Cir Ste 201 San Antonio TX 78258-3341 Ph: (210) 998-5591 |
| NPI Number | 1588923304 |
|---|---|
| Provider Enumeration Date | 05/14/2012 |
| Last Update Date | 01/22/2019 |
| Medicare PECOS PAC ID | 6002110418 |
|---|---|
| Medicare Enrollment ID | O20160205000073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588923304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
| Provider Name | Vanessa Valles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447689385 PECOS PAC ID: 5698905727 Enrollment ID: I20140311000531 |
| Provider Name | Violet K Dakora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831557982 PECOS PAC ID: 9638420169 Enrollment ID: I20180924000766 |
| Provider Name | Karen Marie Christopher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902529613 PECOS PAC ID: 2466820907 Enrollment ID: I20221115000939 |
| Provider Name | Lawrence C. Mack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992936124 PECOS PAC ID: 8729382130 Enrollment ID: I20240606003749 |
| Provider Name | Adriana Alicia Moran |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609602903 PECOS PAC ID: 0042741928 Enrollment ID: I20241002002752 |
| Provider Name | Valerie Jo Vineyard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699097832 PECOS PAC ID: 6406387380 Enrollment ID: I20241002002769 |
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