Provider Demographics
NPI:1801074869
Name:CREWSE, YVONNE (LPC)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:CREWSE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:YVONNE
Other - Middle Name:
Other - Last Name:SPOKERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:410 MALACATE
Mailing Address - Street 2:
Mailing Address - City:AJO
Mailing Address - State:AZ
Mailing Address - Zip Code:85321
Mailing Address - Country:US
Mailing Address - Phone:520-387-5651
Mailing Address - Fax:
Practice Address - Street 1:410 N MALACATE ST
Practice Address - Street 2:
Practice Address - City:AJO
Practice Address - State:AZ
Practice Address - Zip Code:85321-2254
Practice Address - Country:US
Practice Address - Phone:520-387-5651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC12851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC12851OtherLPC