Provider Demographics
NPI:1962659722
Name:CROFT, MICHELLE LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEE
Last Name:CROFT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7007 WYOMING BLVD NE STE D5
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3981
Mailing Address - Country:US
Mailing Address - Phone:505-321-6029
Mailing Address - Fax:
Practice Address - Street 1:7007 WYOMING BLVD NE STE D5
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3981
Practice Address - Country:US
Practice Address - Phone:505-321-6029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-24
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-107011041C0700X
WYLCSW-7221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical