Provider Demographics
NPI:1710598180
Name:CROWN E-THERAPY & CONSULTING LLC
Entity Type:Organization
Organization Name:CROWN E-THERAPY & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:205-335-7437
Mailing Address - Street 1:174 LINWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STERRETT
Mailing Address - State:AL
Mailing Address - Zip Code:35147-7008
Mailing Address - Country:US
Mailing Address - Phone:205-335-7437
Mailing Address - Fax:
Practice Address - Street 1:174 LINWOOD RD
Practice Address - Street 2:
Practice Address - City:STERRETT
Practice Address - State:AL
Practice Address - Zip Code:35147-7008
Practice Address - Country:US
Practice Address - Phone:205-335-7437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty