Provider Demographics
NPI:1255635488
Name:MCVAY, CRYSTAL LYNNE (MA, LPC)
Entity type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:LYNNE
Last Name:MCVAY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 E CAMPUS VIEW BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5616
Mailing Address - Country:US
Mailing Address - Phone:614-310-1234
Mailing Address - Fax:614-310-1237
Practice Address - Street 1:355 E CAMPUS VIEW BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5616
Practice Address - Country:US
Practice Address - Phone:614-310-1234
Practice Address - Fax:614-310-1237
Is Sole Proprietor?:No
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0701129101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional