Organization
CROWE PSYCHOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFERSON MARTIN CROWE PSY.D. (OWNER, CLINICAL PSYCHOLOGIST)
(303) 304-6528
Entity
Organization
Contact information
Practice address
8 FANEUIL HALL MARKETPLACE # 326, BOSTON, MA 02109-6114
(303) 304-6528
Mailing address
664 HUMPHREY ST APT 1, SWAMPSCOTT, MA 01907-2638
(303) 304-6528
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003294562
NATIONAL PROVIDER IDENTIFIER TYPE 1
—
Enumeration date
02/14/2019
Last updated
02/14/2019
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