Provider Demographics
NPI:1861654519
Name:ANDERSON, CRYSTAL DAWN (LMHC, LCPC)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:DAWN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:DAWN
Other - Last Name:WANEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2140 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6279
Mailing Address - Country:US
Mailing Address - Phone:563-421-5710
Mailing Address - Fax:
Practice Address - Street 1:2140 53RD AVE
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-6279
Practice Address - Country:US
Practice Address - Phone:563-421-5700
Practice Address - Fax:563-421-5709
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor