Provider Demographics
NPI:1881800647
Name:CREWS, JUDITH ANNE (LCPC PMFT)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANNE
Last Name:CREWS
Suffix:
Gender:F
Credentials:LCPC PMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 GEKELER LN
Mailing Address - Street 2:APT 8
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-6494
Mailing Address - Country:US
Mailing Address - Phone:208-343-4550
Mailing Address - Fax:
Practice Address - Street 1:12301 W EXPLORER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-1571
Practice Address - Country:US
Practice Address - Phone:208-373-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID3039101YM0800X
ID3032106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist