Crewdson, Mary Ann
Crewdson, Mary Ann is an individual health care provider with primary practice located at 635 Main St , Middletown CT 06457-2718. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Crewdson, Mary Ann can be contacted via phone (860) 347-6971.Contact Information
Primary practice address
635 Main St
Middletown CT 06457-2718
Phone: (860) 347-6971
Fax: (860) 704-8034
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3867 | Oregon |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 007567 | Connecticut |
Profile Details
| NPI number | 1619032232 |
|---|---|
| LBN Legal business name | Crewdson, Mary Ann |
| Credentials | LCSW, CPT, QMHP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Mar 30th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619032232 | NPPES |
| Connecticut | MEDICAID | 004236338 |
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