Provider Demographics
NPI:1053080002
Name:CROTWELL, ALLISON BRELAND (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:BRELAND
Last Name:CROTWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 OLD OAK LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4426
Mailing Address - Country:US
Mailing Address - Phone:205-410-9128
Mailing Address - Fax:
Practice Address - Street 1:2505 OLD OAK LN
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-4426
Practice Address - Country:US
Practice Address - Phone:205-410-9128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-12
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1831C101Y00000X, 104100000X, 251S00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1831COtherALABAMA BOARD OF SOCIAL WORK