Provider Demographics
NPI:1689043846
Name:CROWLEY, MICHELLE PITTMAN (LMSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PITTMAN
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:PITTMAN
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1418 WOODMERE DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-7458
Mailing Address - Country:US
Mailing Address - Phone:504-237-5769
Mailing Address - Fax:
Practice Address - Street 1:1418 WOODMERE DR
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-7458
Practice Address - Country:US
Practice Address - Phone:504-237-5769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9902104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker