MEDICARE: SUSAN L CREWS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MH10664	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558652636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN L CREWS

Provider Business Mailing Address
First Line	:	PO BOX 244
Second Line	:
City	:	BELL
State	:	FL
Zip	:	32619-0244
Country	:	US
Telephone Number	:	386-717-6134
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 NW 27TH LN STE F
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-6600
Country	:	US
Telephone Number	:	386-717-6134
Fax Number	:	352-554-4929

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	10/22/2024

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Directions to “ SUSAN L CREWS ” Practice Location

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