Provider Demographics
NPI:1962570721
Name:CROWLEY, DAVID HARMAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:HARMAN
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 WOODHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-7573
Mailing Address - Country:US
Mailing Address - Phone:217-351-4926
Mailing Address - Fax:
Practice Address - Street 1:100 N CHESTNUT ST
Practice Address - Street 2:RM. 243
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-4856
Practice Address - Country:US
Practice Address - Phone:217-637-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490036671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical