Individual
CRYSTAL LARAYNE HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LAC, MSW
Contact information
Practice address
114 BRISTLECONE DR, FORT COLLINS, CO 80524-2031
(970) 494-4200
Mailing address
4856 INNOVATION DR STE B, FORT COLLINS, CO 80525-5540
(970) 494-4200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001344
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09926433
CO
Other
Enumeration date
10/05/2011
Last updated
03/18/2020
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