Provider Demographics
NPI:1497236525
Name:CROTCHETT, JENNIFER M (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:CROTCHETT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 ALEXANDRA DR
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-6512
Mailing Address - Country:US
Mailing Address - Phone:815-720-9235
Mailing Address - Fax:815-544-2116
Practice Address - Street 1:915 ALEXANDRA DR
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-6512
Practice Address - Country:US
Practice Address - Phone:815-720-9235
Practice Address - Fax:815-544-2116
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health