Provider Demographics
NPI:1043031271
Name:CRYSELL, DEBRA NICOLE (MS, ALC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:NICOLE
Last Name:CRYSELL
Suffix:
Gender:F
Credentials:MS, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 GREENVILLE BYP
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-3729
Mailing Address - Country:US
Mailing Address - Phone:334-437-3983
Mailing Address - Fax:
Practice Address - Street 1:2277 DAMASCUS RD
Practice Address - Street 2:
Practice Address - City:HONORAVILLE
Practice Address - State:AL
Practice Address - Zip Code:36042-5627
Practice Address - Country:US
Practice Address - Phone:334-437-3983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05075101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor