Individual
JENNIFER ELAINE-KETCHAM CROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
2331 42ND AVE SW APT 403, SEATTLE, WA 98116-2557
(213) 359-7984
Mailing address
2331 42ND AVE SW APT 403, SEATTLE, WA 98116-2557
(206) 973-3791
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
115557
CA
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-62932
MT
1041C0700X
Clinical Social Worker
L13917
OR
1041C0700X
Clinical Social Worker
Primary
LW61088339
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115557
BOARD OF BEHAVIORAL SCIENCES
CA
01
—
BBH-LCSW-LIC-62932
BOARD OF BEHAVIORAL HEALTH
MT
01
—
L13917
BOARD OF LICENSED SOCIAL WORKERS
OR
01
—
LW61088339
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
11/07/2018
Last updated
06/27/2023
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