Provider Demographics
NPI:1952505604
Name:CROSBY, MARK E (LPC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:E
Last Name:CROSBY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7408 CALVIN UNDERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-0601
Mailing Address - Country:US
Mailing Address - Phone:225-936-2607
Mailing Address - Fax:225-664-0703
Practice Address - Street 1:11914 JUSTICE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2372
Practice Address - Country:US
Practice Address - Phone:225-936-2607
Practice Address - Fax:225-664-0703
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2611101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional