Individual provider Active NPI

Malissa Kaye Crowe, LCSW

  • Clinical Social Worker
  • West Lafayette, IN
National Provider Identifier
1114965563
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW34005071A Issued in IN
Practice address
1771 Twin Lakes Cir
West Lafayette, IN 47906-4916
Phone
(765) 491-6175
NPI assigned
Jun 4, 2006
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW34005071A IN Primary

Addresses

Primary practice location

1771 Twin Lakes Cir
West Lafayette, IN 47906-4916

Mailing address

1771 Twin Lakes Cir
West Lafayette, IN 47906-4916
Phone (765) 491-6175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061012000023 IN Practitioner - Clinical Social Worker 6204839723 Practice locations: West Lafayette, IN
I20201015000412 AZ Practitioner - Clinical Social Worker 6204839723 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW34005071AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sally a Timmons LLC Clinical PastSince Sep 22, 2005 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1114965563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 TWIN LAKES CIR",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479064916",
            "telephone_number": "765-491-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 TWIN LAKES CIR",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479064916",
            "telephone_number": "765-491-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWE",
        "first_name": "MALISSA",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "SW34005071A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

Verify at the official NPI Registry.