Provider Demographics
NPI:1780689075
Name:CRABTREE, MARY ANN (PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1374
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-4374
Mailing Address - Country:US
Mailing Address - Phone:724-941-1120
Mailing Address - Fax:724-941-0993
Practice Address - Street 1:4150 WASHINGTON RD
Practice Address - Street 2:STE 105
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2534
Practice Address - Country:US
Practice Address - Phone:724-941-1120
Practice Address - Fax:724-941-0993
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006756-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACR513021OtherHIGHMARK
PA123462OtherVALUEOPTIONS
PA940015OtherUBH
PA1036436OtherAETNA HMO
PA0001034873OtherMHN VENDOR
PA30001034873OtherMHN VENDOR #
PA31586OtherINTERGROUP
PA39468OtherOHS
PA80161OtherTRICARE
PA01678996Medicaid
PA163881OtherVBH VENDOR #
PA110061OtherUPMC
PA5564730OtherAETNA NON HMO
PA2058984OtherCIGNA
PAIP03448OtherMAGELLAN
PA80161OtherTRICARE
PARO7254Medicare UPIN