MEDICARE: MARY ANN CRABTREE PSYCHOLOGIST

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	103T00000X	Psychologist	PS-006756-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CR513021	OTHER	PA	HIGHMARK
2	123462	OTHER	PA	VALUEOPTIONS
3	940015	OTHER	PA	UBH
4	1036436	OTHER	PA	AETNA HMO
5	0001034873	OTHER	PA	MHN VENDOR
6	30001034873	OTHER	PA	MHN VENDOR #
7	31586	OTHER	PA	INTERGROUP
8	39468	OTHER	PA	OHS
9	80161	OTHER	PA	TRICARE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	163881	OTHER	PA	VBH VENDOR #
12	110061	OTHER	PA	UPMC
13	5564730	OTHER	PA	AETNA NON HMO
14	2058984	OTHER	PA	CIGNA
15	IP03448	OTHER	PA	MAGELLAN

General Provider Information

NPI Number	:	1780689075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN CRABTREE PSYCHOLOGIST

Provider Business Mailing Address
First Line	:	PO BOX 1374
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-4374
Country	:	US
Telephone Number	:	724-941-1120
Fax Number	:	724-941-0993

Provider Business Practice Location Address
First Line	:	4150 WASHINGTON RD
Second Line	:	STE 105
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2534
Country	:	US
Telephone Number	:	724-941-1120
Fax Number	:	724-941-0993

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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