Provider Demographics
NPI:1952092546
Name:CROWELL, YANNIKA D (LMSW)
Entity Type:Individual
Prefix:MS
First Name:YANNIKA
Middle Name:D
Last Name:CROWELL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:YANNIKA
Other - Middle Name:D
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8209 ROCKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2962
Mailing Address - Country:US
Mailing Address - Phone:443-522-8297
Mailing Address - Fax:
Practice Address - Street 1:3422 E NORTHERN PKWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1624
Practice Address - Country:US
Practice Address - Phone:443-522-8297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18640101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional