Provider Demographics
NPI:1649620782
Name:CROW, KIMBERLY (LPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:CROW
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 1:910 PIERREMONT RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2056
Mailing Address - Country:US
Mailing Address - Phone:318-562-6616
Mailing Address - Fax:
Practice Address - Street 1:910 PIERREMONT RD STE 300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2056
Practice Address - Country:US
Practice Address - Phone:318-562-6616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor