CHRYSTAL FULLEN MS LPC
NPI 1952800658
Counselor - Professional in San Antonio, TX

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since February 08, 2018

4242 WOODCOCK DR STE 201, SAN ANTONIO, TX 78228(210) 481-8673(210) 314-2480 Get Directions Write a Review

NPPES record last updated: February 8, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Authorized Official
Other Providers Same Location
Frequently Asked Questions

Organization
Counselor
Professional

About CHRYSTAL FULLEN MS LPC

This page provides the complete NPI Profile along with additional information for Chrystal Fullen Ms Lpc, a provider established in San Antonio, Texas operating as a Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1952800658 assigned on February 2018. The practitioner's primary taxonomy code is 101YP2500X with license number 71964 (TX). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Chrystal Fullen Lpc (Sole Member)

NPI: 1952800658 Verify this NPI
Provider Name: CHRYSTAL FULLEN MS LPC
Entity Type: Organization
Location Address: 4242 WOODCOCK DR STE 201 SAN ANTONIO, TX 78228
Location Phone: (210) 481-8673
Location Fax: (210) 314-2480
Mailing Address: 4242 WOODCOCK DR STE 201 SAN ANTONIO, TX 78228
Mailing Phone: (210) 481-8673
Mailing Fax: (210) 314-2480
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 02-08-2018
Last Update Date: 02-08-2018
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Counselor Professional
Taxonomy Code: 101YP2500X
Type: Behavioral Health & Social Service Providers
License No.: 71964
License State: TX

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: CHRYSTAL FULLEN LPC
Authorized Official Title: SOLE MEMBER
Authorized Official Phone: (210) 410-3710