Provider Demographics
NPI:1790483816
Name:CROWLEY, HANNA YOUNG (LCMHCA)
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:YOUNG
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:YOUNG
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 FIREWEED PL
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-4568
Mailing Address - Country:US
Mailing Address - Phone:386-237-0260
Mailing Address - Fax:
Practice Address - Street 1:8362 SIX FORKS RD STE 104
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5086
Practice Address - Country:US
Practice Address - Phone:919-709-7307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18543101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health