Provider Demographics
NPI:1669133393
Name:MAJOR BRYAN, CRYSTAL JADE (LMHC)
Entity type:Individual
Prefix:
First Name:CRYSTAL JADE
Middle Name:
Last Name:MAJOR BRYAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JADE
Other - Middle Name:
Other - Last Name:MAJOR BRYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:2140 SW ENGLISH GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8617
Mailing Address - Country:US
Mailing Address - Phone:954-980-5326
Mailing Address - Fax:
Practice Address - Street 1:2054 VISTA PKWY STE 418
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6741
Practice Address - Country:US
Practice Address - Phone:561-221-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-05
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19534101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health