Waites, Crystal A

Waites, Crystal A is an sole proprietor health care provider with primary practice located at 701 Kenmore Ave Ste 105 , Fredericksburg VA 22401-5792. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Waites, Crystal A can be contacted via phone (403) 225-4245.

Contact Information

Primary practice address
701 Kenmore Ave Ste 105 Fredericksburg VA 22401-5792
Phone: (403) 225-4245
Fax: (866) 780-4133
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1551 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 6638 North Carolina
Behavioral Health & Social Service Providers / School 101YS0200X 3036 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701005844 Virginia

Profile Details

NPI number 1669522116
LBN Legal business name Waites, Crystal A
Credentials LPC, LCAS,LSC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2007
Last updated Jul 12th, 2019 - about 5 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 1669522116 NPPES
North Carolina MEDICAID 6103593

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