Provider Demographics
NPI:1609291988
Name:HUFFMAN, CRYSTY A (LCSW)
Entity type:Individual
Prefix:
First Name:CRYSTY
Middle Name:A
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MOTIF BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-1017
Mailing Address - Country:US
Mailing Address - Phone:317-306-1837
Mailing Address - Fax:
Practice Address - Street 1:39 MOTIF BLVD
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1017
Practice Address - Country:US
Practice Address - Phone:317-306-1837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005814A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN945920042Medicare PIN