Provider Demographics
NPI:1841319738
Name:CROW, CAROL J (LMHC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:J
Last Name:CROW
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 MARINER ST
Mailing Address - Street 2:#605
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3424
Mailing Address - Country:US
Mailing Address - Phone:813-915-1038
Mailing Address - Fax:888-218-7138
Practice Address - Street 1:200 S. HOOVER BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609
Practice Address - Country:US
Practice Address - Phone:813-915-1038
Practice Address - Fax:888-218-7138
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4818101YM0800X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral