Healthcare Provider Details

I. General information

NPI: 1508433202
Provider Name (Legal Business Name): HEATHER KATHLEEN CRUTCHFIELD MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S BROAD ST
CLINTON SC
29325-2507
US

IV. Provider business mailing address

250 DEWEY AVE
SPARTANBURG SC
29303-3009
US

V. Phone/Fax

Practice location:
  • Phone: 864-938-2108
  • Fax:
Mailing address:
  • Phone: 864-585-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9731
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: