Provider Demographics
NPI:1033697826
Name:CROWDER, REBECCA KATHERINE (LPCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:KATHERINE
Last Name:CROWDER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:KATHERINE
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1022 PAULA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-9765
Mailing Address - Country:US
Mailing Address - Phone:502-395-1001
Mailing Address - Fax:
Practice Address - Street 1:1022 PAULA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:KY
Practice Address - Zip Code:40342-9765
Practice Address - Country:US
Practice Address - Phone:502-395-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242433101YP2500X
KY272492101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1790731081Medicaid