Provider Demographics
NPI:1669659496
Name:CROWLEY, KEVIN J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 STEEP HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1923
Mailing Address - Country:US
Mailing Address - Phone:203-454-9545
Mailing Address - Fax:
Practice Address - Street 1:177 STEEP HILL RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883-1923
Practice Address - Country:US
Practice Address - Phone:203-454-9545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009999103T00000X, 103TB0200X, 103TC2200X
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool