Provider Demographics
NPI:1902349087
Name:CREWS, JENNY LINDSAY (AUD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:LINDSAY
Last Name:CREWS
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8082
Mailing Address - Country:US
Mailing Address - Phone:860-679-2804
Mailing Address - Fax:
Practice Address - Street 1:263 FARMINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8060
Practice Address - Country:US
Practice Address - Phone:860-679-2804
Practice Address - Fax:860-679-1848
Is Sole Proprietor?:No
Enumeration Date:2016-11-22
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD 60705864231H00000X
CT000733231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2072188Medicaid