Crouch, Marvin Ora

Crouch, Marvin Ora is an sole proprietor health care provider with primary practice located at 2811 30Th Ave , Kearney NE 68845-4036. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Crouch, Marvin Ora can be contacted via phone (308) 237-6865.

Contact Information

Primary practice address
2811 30Th Ave Kearney NE 68845-4036
Phone: (308) 237-6865
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 296 Nebraska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 35 Nebraska
Behavioral Health & Social Service Providers / Professional 101YP2500X 621 Nebraska

Profile Details

NPI number 1407930944
LBN Legal business name Crouch, Marvin Ora
Credentials L.I.M.H.P., L.A.D.C.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2006
Last updated Feb 18th, 2014 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1407930944 NPPES
Nebraska MEDICAID 100025152000
Nebraska MEDICAID 100025152100

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