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General NPI Number Information
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NPI Number | 1194321729
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Entity Type | Organization
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Legal Business Name | AUDREY CROUCH COUNSELING PLLC
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 301 S ROGERS ST STE 205
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City | WAXAHACHIE
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State | TX
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Zip | 75165-3348
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Country | US
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Telephone | 469-297-0682
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Fax |
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Provider Business Mailing Address
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Address Line | 213 BARBARA WAY
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City | RED OAK
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State | TX
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Zip | 75154-6501
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Country | US
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Telephone | 214-228-0659
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUDREY CROUCH
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Credential | LPC, LCDC
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Telephone | 469-297-0682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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