Doctor Name: | MS. PATRICIA CROCKETT |
NPI Number: | 1205244936 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC, SOTP |
License Number: | FC00000178 |
Business Practice Address: | 1905 Bridgeport Way W Suite 201 University Place, WA - 984664846 |
Business Phone Number: | 2534445450 |
Business Fax Number: | 2534445451 |
Mailing Address: | 1905 Bridgeport Way W, Suite 201 UNIVERSITY PLACE |
State: | WA |
Postal Code: | 984664846 |
Phone Number: | 2534445450 |
Fax Number: | 2534445451 |
NPI Enumeration Date: | 07/25/2014 |
NPI Last Update Date: | 07/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | FC00000178 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |