Provider Demographics
NPI:1598841512
Name:CROFT, PAUL L (LMHC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:L
Last Name:CROFT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5551 FRANCES AVE. NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-1422
Mailing Address - Country:US
Mailing Address - Phone:253-952-4147
Mailing Address - Fax:253-661-9190
Practice Address - Street 1:33600 6TH AVE S
Practice Address - Street 2:STE. 212
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6743
Practice Address - Country:US
Practice Address - Phone:253-952-4147
Practice Address - Fax:253-661-9190
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional