Provider Demographics
NPI:1720223233
Name:CROWLEY, KELLEY J (LICSW)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:J
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:JEAN
Other - Last Name:ERRICKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:759 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-9999
Mailing Address - Fax:
Practice Address - Street 1:759 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1619
Practice Address - Country:US
Practice Address - Phone:413-794-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1153771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical