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Organization
DR CRYSTAL MALLOY PHD LPC MAC CEAP LLC
Active
Organization
DR CRYSTAL MALLOY PHD LPC MAC CEAP LLC
Active
Other names
Progressive & Innovative Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL MALLOY PHD, LPC, MAC, CEAP (DIRECTOR/OWNER)
(337) 396-5592
Entity
Organization
Contact information
Practice address
174 SCHOLAR RD, GUYTON, GA 31312-6240
(337) 396-5592
(912) 250-6025
Mailing address
174 SCHOLAR RD, GUYTON, GA 31312-6240
(337) 396-5592
(912) 250-6025
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
Other
Enumeration date
11/13/2025
Last updated
11/13/2025
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