Provider Demographics
NPI:1215662861
Name:CRABTREE, JENNIFER (LMSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 NAPOLEON RD
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49254-1259
Mailing Address - Country:US
Mailing Address - Phone:517-513-4802
Mailing Address - Fax:
Practice Address - Street 1:349 NAPOLEON RD
Practice Address - Street 2:
Practice Address - City:MICHIGAN CENTER
Practice Address - State:MI
Practice Address - Zip Code:49254-1259
Practice Address - Country:US
Practice Address - Phone:517-513-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801098848101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor