Provider Demographics
NPI:1316391287
Name:CROMARTIE, RICHELLE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHELLE
Middle Name:E
Last Name:CROMARTIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 ST THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2999
Mailing Address - Country:US
Mailing Address - Phone:910-988-5943
Mailing Address - Fax:
Practice Address - Street 1:2525 RAEFORD RD STE B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5092
Practice Address - Country:US
Practice Address - Phone:910-491-8901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-22039101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)