Healthcare Provider Details

I. General information

NPI: 1508464215
Provider Name (Legal Business Name): PATRICIA L CROWDER LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2020
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 RIVER CLUB DR STE 200
SUFFOLK VA
23435-3837
US

IV. Provider business mailing address

5131 RIVER CLUB DR STE 200
SUFFOLK VA
23435-3837
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax:
Mailing address:
  • Phone: 804-207-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0710103085
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701009603
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: