Individual
JESSE M CROWDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14805 DETROIT AVE STE 200C, LAKEWOOD, OH 44107-3921
(216) 223-8083
Mailing address
14805 DETROIT AVE STE 200C, LAKEWOOD, OH 44107-3921
(216) 223-8083
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162220
OH
104100000X
Social Worker
S.2106128
OH
1041C0700X
Clinical Social Worker
Primary
I.2304984-SUPV
OH
Other
Enumeration date
02/27/2018
Last updated
05/13/2026
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