Individual
CRYSTAL AHLES
Active
Individual
CRYSTAL AHLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000500
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09923914
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107200
OBH
CO
01
—
1083617344
NPI #
CO
05
—
35975245
—
CO
01
—
840575023
TAX #
CO
Enumeration date
03/09/2013
Last updated
11/06/2020
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