Individual
JUDY L CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
115 CHESTNUT ST APT B, SAINT LOUIS, MI 48880-1308
(989) 502-2735
Mailing address
PO BOX 75, SAINT LOUIS, MI 48880-0075
(989) 502-2735
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401225189
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401016698
STATE OFMICHIGAN
MI
Enumeration date
02/11/2019
Last updated
10/09/2025
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