Gayle Elizabeth Crocker, MHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH14010 Issued in GA

Practice address

8620 SW 12TH St
Pembroke Pines, FL 33025-5323

Phone

(954) 588-3612

Fax

(423) 822-5729

NPI assigned

Sep 26, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1174874473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8620 SW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255323",
            "telephone_number": "954-442-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8620 SW 12TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255323",
            "telephone_number": "954-588-3612",
            "fax_number": "423-822-5729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "GAYLE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH10399",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "FL",
            "license": "716753",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "MH14010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Pembroke Pines, FL
• Providers in Pembroke Pines, 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 Oct 13, 2017; 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.