Provider Demographics
NPI:1730373762
Name:CROOMS, KATHERINE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:CROOMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:STRUNCK-FOBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7148 LAKEHURST AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5436
Mailing Address - Country:US
Mailing Address - Phone:214-531-3316
Mailing Address - Fax:
Practice Address - Street 1:530 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1043
Practice Address - Country:US
Practice Address - Phone:734-764-9466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX607721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical