JUDY L CROCKETT


Address: 115 Chestnut St Apt B, Saint Louis, MI 48880-1308
Phone: 9895022735

JUDY L CROCKETT (NPI# 1730645052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730645052
Entity Type Individual
Full Name JUDY L CROCKETT
Credential MA, LLPC
Practice Address 115 Chestnut St Apt B
Saint Louis
MI 48880-1308
Mailing Address Po Box 75
Saint Louis
MI 48880-0075
Practice Telephone 9895022735
Mailing Telephone 9895022735
Enumeration Date 2019-02-11
Last Update Date 2019-02-11
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
6401016698 MI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI STATE OFMICHIGAN 6401016698 01

Other Providers JUDY CROCKETT

NPI Name Taxonomy Address Enumeration
1063963510 Judy Crockett Registered Nurse 7601 Imperial Hwy, Downey, CA 90242-3456 2016-10-19

Office Location

Street Address 115 CHESTNUT ST APT B
City SAINT LOUIS
State MI
Zip Code 48880-1308

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063036838 Sheril Amilia Rolston Technician/Technologist 223 S Deleware St, Saint Louis, MI 48880 2020-06-08
1376603175 Nancy Louise Parsons Counselor 214 W Saginow St, St Louis, MI 48880 2006-12-11
1396846234 Greg William Lowe Dentist 622 E. Washington Ave., St. Louis, MI 48880 2006-09-25
1598319196 James H Seals Peter B Tacia & Tad J Bartz Od PC Optometrist 235 N Mill St, St Louis, MI 48880 2019-07-31
1922469170 Justin Michael Elliott Occupational Therapist 1149 W Monroe Rd, St. Louis, MI 48880 2016-03-16
1871941880 Gary Dwayne Tegge Technician, Other 616 Maple St, Saint Louis, MI 48880-1335 2016-05-31
1265092589 Mari I Debolt Emergency Medical Technician, Basic 123 N Pine St, Saint Louis, MI 48880-1428 2019-06-18
1013579168 Mari's Cleaning and Senior Care Services Home Health 123 N Pine St, Saint Louis, MI 48880-1428 2019-06-28
1386644839 Evans Drugs of Saint Louis LLC Durable Medical Equipment & Medical Supplies 116 N Mill St, Saint Louis, MI 48880-1521 2005-07-27
1497050454 Aspire Rx LLC Pharmacy 116 N Mill St, Saint Louis, MI 48880-1521 2011-01-21
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1720603830 Kelly Marie Buckley Counselor 5939 Hilgard Pl, Saint Louis, MO 63109-3445 2020-06-15
1407479207 Lauren Elizabeth Summers Counselor 6261 Reber Pl, Saint Louis, MO 63139-2617 2020-05-27
1306469960 Walter Robert Scull Counselor 1300 Kirkham Ave, Saint Louis, MO 63122-3127 2020-05-18
1982226759 David Mcgraw Counselor 28 Reasor Dr, Saint Louis, MO 63135-1125 2020-05-14
1992326565 Chantrell M Carter Counselor 5027 Mardel Ave, Saint Louis, MO 63109-1731 2020-05-05
1508486333 Evelyn Aviva Witten Counselor 130 S Bemiston Ave Ste 604, Saint Louis, MO 63105-1913 2020-04-22
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Competitor

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City SAINT LOUIS
Zip Code 48880

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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