Individual
MR. MARVIN ORA CROUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.I.M.H.P., L.A.D.C.
Contact information
Practice address
2811 30TH AVE, KEARNEY, NE 68845-4036
(308) 237-6865
Mailing address
7450 W 29TH ST, KEARNEY, NE 68845-8808
(308) 234-1148
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
296
NE
101YM0800X
Mental Health Counselor
Primary
35
NE
101YP2500X
Professional Counselor
621
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100025152000
—
NE
05
—
100025152100
—
NE
Enumeration date
10/24/2006
Last updated
02/18/2014
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