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Individual

KEITH L CROWNOVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
3205 TAHITI ST NE, ALBUQUERQUE, NM 87111-5342
(405) 824-9625
Mailing address
3205 TAHITI ST NE, ALBUQUERQUE, NM 87111-5342
(405) 824-9625

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CCMH0219991
NM
101YM0800X
Mental Health Counselor
LPC0017517
CO
101YM0800X
Mental Health Counselor
LPC6141
OK

Other

Enumeration date
06/05/2012
Last updated
11/10/2025
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