Individual
CRYSTAL MCCUBBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, LAC, NCC
Contact information
Practice address
3763 IMPERIAL ST UNIT B, FREDERICK, CO 80516-9409
(719) 924-5499
Mailing address
3763 IMPERIAL ST UNIT B, FREDERICK, CO 80516-9409
(719) 924-5549
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NLC 0105277
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
171W00000X
Contractor
—
—
Other
Enumeration date
12/01/2016
Last updated
11/30/2023
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