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NPI 1740903400

NPI 1740903400 : EDWARD R CREWS LPC : SILOAM SPRINGS, AR

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General NPI Number Information
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    NPI Number           |    1740903400
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    Entity Type          |    Individual 
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    Provider Name        |    EDWARD R CREWS LPC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/19/2022
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    Last Update Date     |    06/06/2025
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Provider Practice Location Address
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    Address Line         |    710 S HOLLY ST STE 10 
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    City                 |    SILOAM SPRINGS
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    State                |    AR
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    Zip                  |    72761-3304
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    Country              |    US
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    Telephone            |    479-524-8618
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2400 S 48TH ST 
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    City                 |    SPRINGDALE
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    State                |    AR
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    Zip                  |    72762-6683
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    Country              |    US
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    Telephone            |    479-750-2020
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health 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        |    171M00000X
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    Taxonomy Name        |    Case Manager/Care Coordinator
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    P2505003
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    License Number State |    AR
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