Provider Demographics
NPI:1932295045
Name:CROWE, JANICE LYNNA (LCSW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LYNNA
Last Name:CROWE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:LYNNA
Other - Last Name:BREIDENSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:P.O. BOX 3229
Mailing Address - Street 2:3541 NORTH CROSSING CIRCLE
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604
Mailing Address - Country:US
Mailing Address - Phone:229-415-8478
Mailing Address - Fax:229-244-4995
Practice Address - Street 1:3541 NORTH CROSSING CIRCLE
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602
Practice Address - Country:US
Practice Address - Phone:229-293-6144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003140104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker