Theresa Crockett, L.M.H.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH5726 Issued in FL

Practice address

1543 Kingsley Ave
Suite 18a
Orange Park, FL 32073-4535

Phone

(904) 269-3324

Fax

(904) 264-2302

NPI assigned

Jan 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Krop & Neidigh

  • Clinical Psychologist
  • Orange Park, FL
  • NPI 1295700029
  NPD (past)
• Krop-Neidigh PA

  • Psychologist
  • Orange Park, FL
  • NPI 1225197544
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1164571683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "SUITE 18A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-269-3324",
            "fax_number": "904-264-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "SUITE 18A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-269-3324",
            "fax_number": "904-264-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "THERESA",
        "credential": "L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Crabtree
• Ashley Craft
• Alexis Marie Craig
• Jennifer Craig, ATC
• Carole J Crane, PH.D., PA
• Rex Cropp, MD
• Anne G Crosby, APRN CNM
• Steven E Crovatto, DMD
• Teresa Marie Crowder, RN
• Barbara Leigh Cruikshank, MD

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.