DAVID HUBERT LARUE CROCKETT PH.D. NPI 1629234620

NPI Information

NPI: 1629234620
Provider Name: DAVID HUBERT LARUE CROCKETT, PH.D.
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
2201 N. 22ND AVE.
SUITE NUMBER A
SHOW LOW, AZ
ZIP 85901
Phone: (928) 537-5696
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David Hubert Larue Crockett, PH.D. is a mental health counselor in Show Low, AZ. David Hubert Larue Crockett, PH.D. NPI is 1629234620. 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:

2201 N. 22ND AVE.
SUITE NUMBER A
SHOW LOW, AZ
ZIP 85901-587
Phone: (928) 537-5696

The enumeration date for this NPI number is 7/30/2008 and was last updated on 7/30/2008.

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	101YM0800X	Counselor	Mental Health	LCSW-12500	ARIZONA	Yes

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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