Provider Demographics
NPI:1619863644
Name:CROUCH, PHOEBE (PLPC)
Entity type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:CROUCH
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 E 85TH TER
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64138-3021
Mailing Address - Country:US
Mailing Address - Phone:816-812-6747
Mailing Address - Fax:
Practice Address - Street 1:6401 ROCKHILL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1122
Practice Address - Country:US
Practice Address - Phone:816-363-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025017241101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health