Provider Demographics
NPI:1275362311
Name:CROWLEY, KATHLEEN MARY (MSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARY
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E WEST HWY APT 214
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6248
Mailing Address - Country:US
Mailing Address - Phone:301-455-7319
Mailing Address - Fax:
Practice Address - Street 1:1215 E WEST HWY APT 214
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6248
Practice Address - Country:US
Practice Address - Phone:301-455-7319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18861104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty