Basic Information
Provider Information
NPI: 1376854315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KING-SADLER
FirstName: CRYSTAL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 639 AMES ST
Address2:  
City: SPRING
State: TX
PostalCode: 773735620
CountryCode: US
TelephoneNumber: 2815134638
FaxNumber:  
Practice Location
Address1: 3737 DACOMA ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770928905
CountryCode: US
TelephoneNumber: 7139707000
FaxNumber: 7139707246
Other Information
ProviderEnumerationDate: 06/24/2010
LastUpdateDate: 09/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X64688TXY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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