Individual provider Active NPI

Justin Edward Crowder, M.ED.

  • Professional Counselor
  • Jackson, TN
National Provider Identifier
1013284058
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
60 Lynoak CV
Suite C
Jackson, TN 38305-2909
Phone
(731) 668-7593
Fax
(731) 660-7512
NPI assigned
Nov 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

60 Lynoak CV
Suite C
Jackson, TN 38305-2909

Mailing address

60 Lynoak CV
Suite C
Jackson, TN 38305-2909
Phone (731) 668-7593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1013284058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 LYNOAK CV",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052909",
            "telephone_number": "731-668-7593",
            "fax_number": "731-660-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 LYNOAK CV",
            "address_2": "SUITE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052909",
            "telephone_number": "731-668-7593",
            "fax_number": "731-660-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWDER",
        "first_name": "JUSTIN",
        "middle_name": "EDWARD",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.