Organization
CRYSTAL E. NICKERSON
Active
Other names
Choice Behavioral Health & Consultation Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL E NICKERSON (DIRECTOR)
(336) 508-8190
Entity
Organization
Contact information
Practice address
2302 W. MEADOWVIEW ROAD SUITE 228, GREENSBORO, NC 27407-6012
(336) 218-5176
(336) 854-0279
Mailing address
2302 W. MEADOWVIEW ROAD SUITE 228; BOX 24, GREENSBORO, NC 27407-6012
(336) 218-5176
(336) 854-0279
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770813016
—
NC
Enumeration date
01/08/2010
Last updated
08/01/2019
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