Provider Demographics
NPI:1750847844
Name:CROWE PSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:CROWE PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERSON
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:303-304-6528
Mailing Address - Street 1:664 HUMPHREY ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2638
Mailing Address - Country:US
Mailing Address - Phone:303-304-6528
Mailing Address - Fax:
Practice Address - Street 1:8 FANEUIL HALL MARKETPLACE # 326
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-6114
Practice Address - Country:US
Practice Address - Phone:303-304-6528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003294562OtherNATIONAL PROVIDER IDENTIFIER TYPE 1