Provider Demographics
NPI:1164100939
Name:BABB, JAMIE ELAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ELAINE
Last Name:BABB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:ELAINE
Other - Last Name:CROCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3965 S DESERT SKY DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-1408
Mailing Address - Country:US
Mailing Address - Phone:928-366-8502
Mailing Address - Fax:
Practice Address - Street 1:3965 S DESERT SKY DR
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-1408
Practice Address - Country:US
Practice Address - Phone:928-366-8502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-214691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical