Provider Demographics
NPI:1043485410
Name:CRUTCHFIELD, MARSHA MORRIS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:MORRIS
Last Name:CRUTCHFIELD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266
Mailing Address - Country:US
Mailing Address - Phone:832-548-5076
Mailing Address - Fax:713-523-4897
Practice Address - Street 1:5602 LYONS AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020
Practice Address - Country:US
Practice Address - Phone:832-548-5400
Practice Address - Fax:713-523-4897
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60623101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080462703Medicaid
TX671849Medicare Oscar/Certification