Provider Demographics
NPI:1467402230
Name:CROWDER, MARY ANN (EDD, LMHC, NCC, CAP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:CROWDER
Suffix:
Gender:F
Credentials:EDD, LMHC, NCC, CAP
Other - Prefix:
Other - First Name:MARYANN
Other - Middle Name:CROWDER
Other - Last Name:STEFANCHIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDD, LMHC, NCC, CAP
Mailing Address - Street 1:698 DRUID PARK DRIVE WEST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6308
Mailing Address - Country:US
Mailing Address - Phone:727-744-5477
Mailing Address - Fax:727-535-6020
Practice Address - Street 1:698 DRUID PARK DR W
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6309
Practice Address - Country:US
Practice Address - Phone:727-744-5477
Practice Address - Fax:727-535-6020
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6468, CAP 1650101YA0400X
FLMH6468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)