1831408079 NPI number — DEBRA VOGT CROWDER LICSW, LCSW, BCD

Table of content: DEBRA VOGT CROWDER LICSW, LCSW, BCD (NPI 1831408079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831408079 NPI number — DEBRA VOGT CROWDER LICSW, LCSW, BCD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CROWDER
Provider First Name:
DEBRA
Provider Middle Name:
VOGT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW, LCSW, BCD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VOGT
Provider Other First Name:
DEBRA
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LICSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831408079
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 80 BOX 16732
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96367-0070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-706-9516
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18TH MEDICAL GROUP
Provider Second Line Business Practice Location Address:
UNIT 5142
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96368-5142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-706-9516
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  115430 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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