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General NPI Number Information
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NPI Number | 1952505604
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Entity Type | Individual
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Provider Name | MARK E. CROSBY LPC
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Gender | Male
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11914 JUSTICE AVE
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City | BATON ROUGE
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State | LA
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Zip | 70816-2372
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Country | US
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Telephone | 225-936-2607
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Fax | 225-664-0703
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Provider Business Mailing Address
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Address Line | 7408 CALVIN UNDERWOOD LN
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City | DENHAM SPRINGS
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State | LA
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Zip | 70706-0601
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Country | US
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Telephone | 225-936-2607
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Fax | 225-664-0703
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2611
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License Number State | LA
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