Provider Demographics
NPI:1699432690
Name:CROWDER, STEPHEN ASHLEY (BCBA)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ASHLEY
Last Name:CROWDER
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 OLDE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8763
Mailing Address - Country:US
Mailing Address - Phone:601-940-3350
Mailing Address - Fax:
Practice Address - Street 1:110 STONEBROOK DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-6002
Practice Address - Country:US
Practice Address - Phone:601-940-3350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-24
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS160020103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst