Healthcare Provider Details

I. General information

NPI: 1720676042
Provider Name (Legal Business Name): BRIGITTE CROWELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2021
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 PUERTA DEL SOL STE 337
SAN CLEMENTE CA
92673-6310
US

IV. Provider business mailing address

1201 PUERTA DEL SOL STE 337
SAN CLEMENTE CA
92673-6310
US

V. Phone/Fax

Practice location:
  • Phone: 949-303-6631
  • Fax:
Mailing address:
  • Phone: 949-303-6631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW29297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: