Provider Demographics
NPI:1639502156
Name:CROUCH, LAWRENCE JOSEPH (MSSW)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:JOSEPH
Last Name:CROUCH
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4019 ARNO RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8002
Mailing Address - Country:US
Mailing Address - Phone:865-567-2175
Mailing Address - Fax:
Practice Address - Street 1:449 MCCARN CIR
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-4176
Practice Address - Country:US
Practice Address - Phone:865-453-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical