Individual provider · NPI-1

Crystal Boateng

Social Worker, Clinical · Waldorf, MD

NPI number1184086605

StatusActive

Last updated in NPPESMay 28, 2026

Details

NPI: 1184086605
Entity type: Individual (NPI-1)
Name: Crystal Boateng
Sex: Female
Sole proprietor: No
Enumeration date: Mar 23, 2016
Certification date: May 28, 2026
Last updated: May 28, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
1041C0700X	Social Worker, Clinical	–	–	Yes
103K00000X	Behavior Analyst	–	–
101YP2500X	Counselor, Professional	–	–
101YS0200X	Counselor, School	–	–
101Y00000X	Counselor	–	–
101YM0800X	Counselor, Mental Health	–	–
1041S0200X	Social Worker, School	–	–

Practice location

1036 Saint Nicholas Dr
Waldorf, MD 20603-4757

Phone 410-934-0580

Mailing address

6120 Black Oak Ct
Fredericksburg, VA 22407-9241

Phone 571-288-6246

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