Provider Demographics
NPI:1184784472
Name:CRABTREE, DAVID OWEN (LCSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:OWEN
Last Name:CRABTREE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CHERRYFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04622-4271
Mailing Address - Country:US
Mailing Address - Phone:207-242-9677
Mailing Address - Fax:855-742-3182
Practice Address - Street 1:150 BLACKS WOODS RD STE D
Practice Address - Street 2:
Practice Address - City:CHERRYFIELD
Practice Address - State:ME
Practice Address - Zip Code:04622
Practice Address - Country:US
Practice Address - Phone:207-242-9677
Practice Address - Fax:855-742-3182
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC165981041C0700X
CALCS175311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical