Provider Demographics
NPI:1659866648
Name:CRAREY, DENISE C
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:C
Last Name:CRAREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10600 CRIMSON TREE CT
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9705
Mailing Address - Country:US
Mailing Address - Phone:202-437-2545
Mailing Address - Fax:
Practice Address - Street 1:10600 CRIMSON TREE CT
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9705
Practice Address - Country:US
Practice Address - Phone:202-437-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC5673101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional