Provider Demographics
NPI:1144605387
Name:QUAZI, KRUTI (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:KRUTI
Middle Name:
Last Name:QUAZI
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 STRAFFORD AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3317
Mailing Address - Country:US
Mailing Address - Phone:610-613-7823
Mailing Address - Fax:
Practice Address - Street 1:175 STRAFFORD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3317
Practice Address - Country:US
Practice Address - Phone:610-613-7823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008245101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health