A Crystal Mind
Nurse Practitioner, Psych/Mental Health in Cincinnati, OH. Organization (NPI-2).
NPI number1467068262
StatusActive
Last updated in NPPESJan 16, 2021
Details
- NPI
- 1467068262
- Entity type
- Organization (NPI-2)
- Legal business name
- A Crystal Mind
- Organization subpart
- No
- Enumeration date
- Sep 17, 2020
- Certification date
- Jan 16, 2021
- Last updated
- Jan 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | |
| 3104A0625X | Assisted Living Facility, Assisted Living, Mental Illness | – | – | |
| 310500000X | Intermediate Care Facility, Mental Illness | – | – | |
| 311500000X | Alzheimer Center (Dementia Center) | – | – | |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – |
Practice location
4015 Executive Park Dr Ste 310Cincinnati, OH 45241-4015
Phone 513-923-6336 · Fax 562-261-1296
Mailing address
Po Box 1441West Chester, OH 45071-1441
Phone 513-923-6336 · Fax 562-261-1296
Authorized official
Crystal Farrell
Owner
5139236336
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