Provider Demographics
NPI:1801667696
Name:MARY LAUREN O'CROWLEY PLLC
Entity type:Organization
Organization Name:MARY LAUREN O'CROWLEY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCPC
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:O'CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-326-3678
Mailing Address - Street 1:3746 N WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5253
Mailing Address - Country:US
Mailing Address - Phone:303-594-0175
Mailing Address - Fax:
Practice Address - Street 1:3746 N WAYNE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-5253
Practice Address - Country:US
Practice Address - Phone:303-594-0175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty