| Doctor Name: | MS. CONNIE PHILLIPS CROWDER |
| NPI Number: | 1003825142 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 2629-123 |
| Business Practice Address: | 565 Milwaukee Ave Suite 3c Burlington, WI - 531051254 |
| Business Phone Number: | 2627570016 |
| Business Fax Number: | 2627570018 |
| Mailing Address: | 565 Milwaukee Ave, Suite 3c BURLINGTON |
| State: | WI |
| Postal Code: | 531051254 |
| Phone Number: | 2627570016 |
| Fax Number: | 2627570018 |
| NPI Enumeration Date: | 08/07/2006 |
| NPI Last Update Date: | 12/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2629-123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |