| Crowder Family Counseling & Therapy Services Inc | |
|
3070 Canyon Vista Dr Colton CA 92324-9770 | |
| (909) 653-0703 | |
| (888) 245-9901 |
| Full Name | Crowder Family Counseling & Therapy Services Inc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3070 Canyon Vista Dr, Colton, California |
| Authorized Official Name and Position | Lucille Crowder (LMFT) |
| Authorized Official Contact | 9096530703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crowder Family Counseling & Therapy Services Inc 3070 Canyon Vista Dr Colton CA 92324-9770 Ph: (909) 653-0703 | Crowder Family Counseling & Therapy Services Inc 3070 Canyon Vista Dr Colton CA 92324-9770 Ph: (909) 653-0703 |
| NPI Number | 1164148995 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 06/04/2024 |
| Certification Date | 06/04/2024 |
| Medicare PECOS PAC ID | 9335681436 |
|---|---|
| Medicare Enrollment ID | O20240604003665 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164148995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Lucille Crowder |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982046371 PECOS PAC ID: 0244772341 Enrollment ID: I20240604004197 |
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