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Contact Information

MARY R ALDRED CROUCH, MSW, MPH, LICSW, MAC
1 KENTON DR STE 200
CHARLESTON, WV25311-1256
 Phone: 304-513-3495
 Fax: 800-734-8498
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for MARY R ALDRED CROUCH · (Female)

NPI Number 1326198094
Status Active
Credentials MSW, MPH, LICSW, MAC
Entity Individual
Enumeration date 01/12/2007
Last updated 04/10/2026 - About 2 months ago
Sole proprietor 1 Yes
Identifiers
  • License # 510829
  • WV License # DP00942200
  • WV Other Q45603G MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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