Dalebroux, Crystal Lynn
Dalebroux, Crystal Lynn is an individual health care provider with primary practice located at 7818 Big Sky Dr Ste 101 , Madison WI 53719-2840. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Dalebroux, Crystal Lynn can be contacted via phone (608) 203-6267.Contact Information
Primary practice address
7818 Big Sky Dr Ste 101
Madison WI 53719-2840
Phone: (608) 203-6267
Fax: (608) 203-6696
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 773-124 | Wisconsin |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15321-132 | Wisconsin |
Profile Details
| NPI number | 1881718294 |
|---|---|
| LBN Legal business name | Dalebroux, Crystal Lynn |
| Credentials | LMFT CSAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Nov 29th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881718294 | NPPES |
| Wisconsin | MEDICAID | 100002735 |
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