Provider Demographics
NPI:1336905488
Name:CROW, JANIE (MS, LAC)
Entity Type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:CROW
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 REBECCA RD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-5010
Mailing Address - Country:US
Mailing Address - Phone:405-808-6829
Mailing Address - Fax:
Practice Address - Street 1:777 MATHIAS DR STE A
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0816
Practice Address - Country:US
Practice Address - Phone:066-347-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2309006101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor