Provider Demographics
NPI:1134787674
Name:CROWLEY, TASHINIKA (LPC)
Entity type:Individual
Prefix:
First Name:TASHINIKA
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CHARTLEIGH CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-1210
Mailing Address - Country:US
Mailing Address - Phone:601-720-9945
Mailing Address - Fax:
Practice Address - Street 1:108 CHARTLEIGH CIR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-1210
Practice Address - Country:US
Practice Address - Phone:601-720-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2025-03-12
Deactivation Date:2019-11-13
Deactivation Code:
Reactivation Date:2020-03-25
Provider Licenses
StateLicense IDTaxonomies
MS2393101YP2500X
TN5439101YP2500X
TX90614101YP2500X
ID9001101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional