# CRYSTAL MENTAL HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598572406
- **Authorized official:** MAKEBA MATTHEWS (OWNER)
- **Authorized official phone:** (704) 584-7741

## Contact information

- **Practice address:** 3718 AUTUMN GOLD CT, CHARLOTTE, NC 28278-7287
- **Practice address phone:** (704) 584-7741
- **Mailing address:** 3718 AUTUMN GOLD CT, CHARLOTTE, NC 28278-7287
- **Mailing address phone:** (704) 584-7741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/13/2024
- **Last updated:** 12/13/2024