Healthcare Provider Details

I. General information

NPI: 1396233870
Provider Name (Legal Business Name): MICHAEL GEORGE CROWLEY LCPC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL CROWLEY LCPC, NCC

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5850 WATERLOO RD STE 230
COLUMBIA MD
21045-1943
US

IV. Provider business mailing address

5850 WATERLOO RD STE 230
COLUMBIA MD
21045-1943
US

V. Phone/Fax

Practice location:
  • Phone: 410-490-7851
  • Fax:
Mailing address:
  • Phone: 410-490-7851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC8647
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: