Individual
CRYSTAL ELENA DELIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCADC
Contact information
Practice address
220 JACK MARTIN BLVD # E2, BRICK, NJ 08724-7772
(732) 920-3434
(732) 920-2447
Mailing address
453 BARBER AVE, BRICK, NJ 08723-5304
(718) 216-2119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
36LC00265000
NJ
101YM0800X
Mental Health Counselor
Primary
37PC00592000
NJ
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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