Provider Demographics
NPI:1982843603
Name:CROUCH, MINDY S (LCSW, LIMHP)
Entity Type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:S
Last Name:CROUCH
Suffix:
Gender:F
Credentials:LCSW, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20921 MAPLE CIR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-4274
Mailing Address - Country:US
Mailing Address - Phone:402-321-8995
Mailing Address - Fax:
Practice Address - Street 1:3213 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-4707
Practice Address - Country:US
Practice Address - Phone:402-321-8995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1226, 3193, 5101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical