SAMUEL WILLIAM CROUCH PLADC NPI 1619452943

NPI Information

NPI: 1619452943
Provider Name: SAMUEL WILLIAM CROUCH, PLADC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
921 W 36TH ST
SCOTTSBLUFF, NE
ZIP 69361
Phone: (308) 225-0500
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Samuel William Crouch, PLADC is a mental health counselor in Scottsbluff, NE. Samuel William Crouch, PLADC NPI is 1619452943. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

921 W 36TH ST
SCOTTSBLUFF, NE
ZIP 69361-009
Phone: (308) 225-0500

The enumeration date for this NPI number is 10/2/2018 and was last updated on 4/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	P-1628	NEBRASKA	No
2	101YM0800X	Counselor	Mental Health	11806	NEBRASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10026769300	MEDICAID	NEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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