Dalebroux, Crystal Lynn

Dalebroux, Crystal Lynn is an individual health care provider with primary practice located at 7818 Big Sky Dr Ste 101 , Madison WI 53719-2840. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Dalebroux, Crystal Lynn can be contacted via phone (608) 203-6267.

Contact Information

Primary practice address
7818 Big Sky Dr Ste 101 Madison WI 53719-2840
Phone: (608) 203-6267
Fax: (608) 203-6696
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 773-124 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15321-132 Wisconsin

Profile Details

NPI number 1881718294
LBN Legal business name Dalebroux, Crystal Lynn
Credentials LMFT CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2007
Last updated Nov 29th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881718294 NPPES
Wisconsin MEDICAID 100002735

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