Individual provider · Type 1 NPI

Jerry Crockrell

Addiction (Substance Use Disorder) Counselor · Manteno, IL

NPI number 1245799378 Active

Practice location

411 W Division St
Manteno, IL 60950-1065

Call (815) 432-5241 Map

Mailing address

136 N Arbor Trl
Park Forest, IL 60466-2604

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1245799378

Jerry Crockrell's National Provider Identifier is 1245799378, issued on Mar 18, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Manteno, IL. The record was last updated on Mar 17, 2020.