Provider Demographics
NPI:1144560822
Name:CRYSTAL ZINN COUNSELING LLC
Entity type:Organization
Organization Name:CRYSTAL ZINN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZINN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-274-0243
Mailing Address - Street 1:P.O. BOX 1765
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653
Mailing Address - Country:US
Mailing Address - Phone:508-274-0243
Mailing Address - Fax:
Practice Address - Street 1:165 ROUTE 6A
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653
Practice Address - Country:US
Practice Address - Phone:508-274-0243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty