Healthcare Provider Details

I. General information

NPI: 1336983790
Provider Name (Legal Business Name): CRABTREE COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 JUDSON RD STE 200
LONGVIEW TX
75601-3922
US

IV. Provider business mailing address

1221 JUDSON RD STE 200
LONGVIEW TX
75601-3922
US

V. Phone/Fax

Practice location:
  • Phone: 903-736-0093
  • Fax:
Mailing address:
  • Phone: 903-736-0093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDI CRABTREE
Title or Position: OWNER
Credential: PHD, LPC
Phone: 903-736-0093