Healthcare Provider Details

I. General information

NPI: 1649757147
Provider Name (Legal Business Name): KATHLEEN MARY CROWLEY MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHLEEN KRIEGER BORSARI

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 12TH AVE
SAN FRANCISCO CA
94122-3515
US

IV. Provider business mailing address

1615 12TH AVE
SAN FRANCISCO CA
94122-3515
US

V. Phone/Fax

Practice location:
  • Phone: 415-205-1550
  • Fax:
Mailing address:
  • Phone: 415-205-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152842
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: