Provider Demographics
NPI:1366113896
Name:CROSBY, TERESA MARIE (BSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:CROSBY
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:MARIE
Other - Last Name:PRYOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:707 W MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2943
Mailing Address - Country:US
Mailing Address - Phone:313-344-9099
Mailing Address - Fax:
Practice Address - Street 1:707 W MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2943
Practice Address - Country:US
Practice Address - Phone:313-344-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2025-06-11
Deactivation Date:2024-09-14
Deactivation Code:
Reactivation Date:2025-06-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)