Provider Demographics
NPI:1689774762
Name:CROUCH, TIMOTHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:CROUCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 WOLFF CT STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3692
Mailing Address - Country:US
Mailing Address - Phone:720-272-9272
Mailing Address - Fax:303-430-5306
Practice Address - Street 1:8670 WOLFF CT STE 130
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3692
Practice Address - Country:US
Practice Address - Phone:720-272-9272
Practice Address - Fax:303-430-5306
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1457103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical