Individual
CRYSTAL MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHA-R, PHN
Contact information
Practice address
63158 DESCHUTES MARKET RD, 337, BEND, OR 97701-2973
(458) 600-8552
Mailing address
63158 DESCHUTES MARKET RD, 337, BEND, OR 97701-2973
(458) 600-8552
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-24-3590
OR
101YM0800X
Mental Health Counselor
23-QMHA-R-3759
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/05/2024
Last updated
01/17/2025
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