Healthcare Provider Details

I. General information

NPI: 1609343375
Provider Name (Legal Business Name): ANNE ELIZABETH CRUNK PHD, NCC, LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5652 SHIELDS DR
BETHESDA MD
20817-3574
US

IV. Provider business mailing address

5652 SHIELDS DR
BETHESDA MD
20817-3574
US

V. Phone/Fax

Practice location:
  • Phone: 301-202-4677
  • Fax:
Mailing address:
  • Phone: 301-202-4677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP17381
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: