Brooks, Crystal Anita

Brooks, Crystal Anita is an sole proprietor health care provider with primary practice located at 12550 New Brittany Blvd Ste 100 , Fort Myers FL 33907-3655. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Brooks, Crystal Anita can be contacted via phone (239) 343-9180.

Contact Information

Primary practice address
12550 New Brittany Blvd Ste 100 Fort Myers FL 33907-3655
Phone: (239) 343-9180
Fax: (239) 343-9188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY003689 Georgia
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY8201 Florida

Profile Details

NPI number 1992285415
LBN Legal business name Brooks, Crystal Anita
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2018
Last updated Dec 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992285415 NPPES
Florida MEDICAID 120337600

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