Provider Demographics
NPI:1386100246
Name:CROMARTIE, DORIS DAY (MA, RMHCI)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:DAY
Last Name:CROMARTIE
Suffix:
Gender:F
Credentials:MA, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 N 50TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-2302
Mailing Address - Country:US
Mailing Address - Phone:813-635-0606
Mailing Address - Fax:
Practice Address - Street 1:3107 N 50TH ST STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-2302
Practice Address - Country:US
Practice Address - Phone:813-635-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38481OtherCONTROL NO FROM STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALIT