Provider Demographics
NPI:1346468055
Name:CROOK, AMY JENELLE (LMFT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JENELLE
Last Name:CROOK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 SW CAMPUS DR # 376
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-6473
Mailing Address - Country:US
Mailing Address - Phone:406-350-2094
Mailing Address - Fax:065-356-0484
Practice Address - Street 1:6532 DASH POINT BLVD NE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-1334
Practice Address - Country:US
Practice Address - Phone:406-350-2094
Practice Address - Fax:406-535-6048
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001983106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist