Provider Demographics
NPI:1639674369
Name:MCCROWELL, KELLY SCHMID (PHD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:SCHMID
Last Name:MCCROWELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 WHITE RABBIT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-2662
Mailing Address - Country:US
Mailing Address - Phone:804-323-0157
Mailing Address - Fax:
Practice Address - Street 1:301 N. 9TH STREET
Practice Address - Street 2:PSYCHOLOGICAL SERVICES/EXCEPTIONAL EDUCATION
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219
Practice Address - Country:US
Practice Address - Phone:804-780-7850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool