Provider Demographics
NPI:1790332062
Name:CROWELL, TRACY PIILANI (MSCP, MHC, NCC, EAP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:PIILANI
Last Name:CROWELL
Suffix:
Gender:F
Credentials:MSCP, MHC, NCC, EAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53-004 HALAI PL
Mailing Address - Street 2:
Mailing Address - City:HAUULA
Mailing Address - State:HI
Mailing Address - Zip Code:96717-9630
Mailing Address - Country:US
Mailing Address - Phone:808-293-0280
Mailing Address - Fax:808-293-0280
Practice Address - Street 1:53-004 HALAI PL
Practice Address - Street 2:
Practice Address - City:HAUULA
Practice Address - State:HI
Practice Address - Zip Code:96717-9630
Practice Address - Country:US
Practice Address - Phone:808-293-0280
Practice Address - Fax:808-293-0280
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health