Provider Demographics
NPI:1184962631
Name:CROWLEY, LISA A (LPC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 KEENEY LN
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4415
Mailing Address - Country:US
Mailing Address - Phone:860-884-4861
Mailing Address - Fax:
Practice Address - Street 1:165 STATE ST
Practice Address - Street 2:SUITE 422
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-6343
Practice Address - Country:US
Practice Address - Phone:860-884-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional