MEDICARE: KATHERINE CROWLEY LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW 0625	AZ
2	1041C0700X	Clinical Social Worker	LICSW1142514	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215990262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE CROWLEY LICSW

Provider Business Mailing Address
First Line	:	13242 N 28TH PL
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-6002
Country	:	US
Telephone Number	:	602-573-6621
Fax Number	:	623-487-9631

Provider Business Practice Location Address
First Line	:	4646 E GREENWAY RD STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-4805
Country	:	US
Telephone Number	:	602-573-6621
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	02/11/2026

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Directions to “ KATHERINE CROWLEY LICSW” Practice Location

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