Healthcare Provider Details

I. General information

NPI: 1841319738
Provider Name (Legal Business Name): CAROL J CROW LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S. HOOVER BLVD SUITE 170
TAMPA FL
33609
US

IV. Provider business mailing address

5701 MARINER ST #605
TAMPA FL
33609-3424
US

V. Phone/Fax

Practice location:
  • Phone: 813-915-1038
  • Fax: 888-218-7138
Mailing address:
  • Phone: 813-915-1038
  • Fax: 888-218-7138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH4818
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: