Provider Demographics
NPI:1194043935
Name:DONALD J CROWDER LSCSW LLC
Entity Type:Organization
Organization Name:DONALD J CROWDER LSCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JERALD
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-207-6062
Mailing Address - Street 1:220 SW 33RD ST
Mailing Address - Street 2:TREC
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2230
Mailing Address - Country:US
Mailing Address - Phone:785-207-6062
Mailing Address - Fax:
Practice Address - Street 1:2625 SW BERKSHIRE DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4875
Practice Address - Country:US
Practice Address - Phone:785-207-6062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS21411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty