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Individual

MR. JEFFREY STEWART CROUCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW-C

Contact information

Practice address
10632 LITTLE PATUXENT PKWY, SUITE 313, COLUMBIA, MD 21044-3273
(443) 538-1247
(443) 276-6640
Mailing address
10632 LITTLE PATUXENT PKWY, SUITE 313, COLUMBIA, MD 21044-3273
(443) 538-1247
(410) 740-2421

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
06143
MD
1041C0700X
Clinical Social Worker
Primary
06143
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
215051400
MD
Enumeration date
06/13/2006
Last updated
01/23/2017
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