Provider Demographics
NPI:1073774212
Name:CROSBY, CAROL D (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:D
Last Name:CROSBY
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 1:1449 VALHALLA DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-5457
Mailing Address - Country:US
Mailing Address - Phone:617-513-2361
Mailing Address - Fax:
Practice Address - Street 1:1449 VALHALLA DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-5457
Practice Address - Country:US
Practice Address - Phone:617-513-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4104101YM0800X
NC14804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health