Provider Demographics
NPI:1972212165
Name:JENNIFER A. CRUMLISH PHD LLC
Entity type:Organization
Organization Name:JENNIFER A. CRUMLISH PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:C
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-233-6950
Mailing Address - Street 1:5225 WISCONSIN AVE NW STE 513
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2024
Mailing Address - Country:US
Mailing Address - Phone:240-233-6950
Mailing Address - Fax:202-364-0561
Practice Address - Street 1:5225 WISCONSIN AVE NW STE 513
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2024
Practice Address - Country:US
Practice Address - Phone:240-233-6950
Practice Address - Fax:202-364-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty