Provider Demographics
NPI:1932807799
Name:CROCHIERE, KEITH R (LMHC)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:R
Last Name:CROCHIERE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3011
Mailing Address - Country:US
Mailing Address - Phone:508-743-5678
Mailing Address - Fax:
Practice Address - Street 1:119 CEDAR ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3011
Practice Address - Country:US
Practice Address - Phone:774-470-4535
Practice Address - Fax:508-743-5699
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1685101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor