Crockett, Michael

Crockett, Michael is an sole proprietor health care provider with primary practice located at 4316 Se 182Nd Ave , Gresham OR 97030-5058. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Group Psychotherapy, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Crockett, Michael can be contacted via phone (503) 893-2249.

Contact Information

Primary practice address
4316 Se 182Nd Ave Gresham OR 97030-5058
Phone: (503) 893-2249
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Behavioral Health & Social Service Providers / Group Psychotherapy 103TP2701X
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1780074807
LBN Legal business name Crockett, Michael
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 27th, 2015
Last updated Mar 2nd, 2022 - about 2 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.

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