Provider Demographics
NPI:1831408079
Name:CROWDER, DEBRA VOGT (LICSW, LCSW, BCD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:VOGT
Last Name:CROWDER
Suffix:
Gender:F
Credentials:LICSW, LCSW, BCD
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:VOGT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:PSC 80 BOX 16732
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96367-0070
Mailing Address - Country:US
Mailing Address - Phone:781-706-9516
Mailing Address - Fax:
Practice Address - Street 1:18TH MEDICAL GROUP
Practice Address - Street 2:UNIT 5142
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5142
Practice Address - Country:US
Practice Address - Phone:781-706-9516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1154301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical