Lim, Crystal Stack

Lim, Crystal Stack is an individual health care provider with primary practice located at One Hospital Dr , Columbia MO 65212-0001. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is her primary health care specialty. Lim, Crystal Stack can be contacted via phone (573) 882-1561.

Contact Information

Primary practice address
One Hospital Dr Columbia MO 65212-0001
Phone: (573) 882-1561
Fax: (573) 884-1889
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2022015232 Missouri
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2022015232 Missouri

Profile Details

NPI number 1356625081
LBN Legal business name Lim, Crystal Stack
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2011
Last updated Apr 10th, 2024 - about 7 months 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 1356625081 NPPES
Mississippi MEDICAID 05908053
Mississippi MEDICAID 490113666

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