Provider Demographics
NPI:1497274583
Name:CREWS, CHARLES R (PHD, LPC-S)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:R
Last Name:CREWS
Suffix:
Gender:M
Credentials:PHD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7903 BANGOR AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2811
Mailing Address - Country:US
Mailing Address - Phone:806-789-8638
Mailing Address - Fax:
Practice Address - Street 1:7903 BANGOR AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2811
Practice Address - Country:US
Practice Address - Phone:806-789-8638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17780101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional