Provider Demographics
NPI:1629525696
Name:CRUMLEY, TIMOTHY SCOTT (LMHC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:CRUMLEY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COLVIN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1242
Mailing Address - Country:US
Mailing Address - Phone:518-438-2222
Mailing Address - Fax:
Practice Address - Street 1:10 COLVIN AVE STE 102
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1242
Practice Address - Country:US
Practice Address - Phone:585-490-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health