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NPI Code Detail

MEDICARE: COURTNIE CRUM BCBA

MEDICARE: COURTNIE CRUM BCBA
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
1103K00000XBehavior AnalystGA

General Provider Information

NPI Number : 1922629922
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNIE CRUM BCBA
Provider Business Mailing Address
First Line : 8201 CASS AVE
Second Line :
City : DARIEN
State : IL
Zip : 60561-5314
Country : US
Telephone Number : 630-590-5571
Fax Number :
Provider Business Practice Location Address
First Line : 3070 BUSINESS PARK DR STE B
Second Line :
City : NORCROSS
State : GA
Zip : 30071-1428
Country : US
Telephone Number : 770-884-1050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2020
Last Update Date : 12/18/2025

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