Provider Demographics
NPI:1801469648
Name:FICKER, CRYSTAL C
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:C
Last Name:FICKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BEECH GLEN DR
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-9746
Mailing Address - Country:US
Mailing Address - Phone:828-686-3451
Mailing Address - Fax:
Practice Address - Street 1:56 BEECH GLEN DR
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-9746
Practice Address - Country:US
Practice Address - Phone:828-505-5636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC008796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health