Basic Information
| Provider Information | |||||||||
| NPI: | 1043301807 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CROOK | ||||||||
| FirstName: | JON | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMFT, LCDC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3840 HULEN ST STE 602 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761077275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177354165 | ||||||||
| FaxNumber: | 8177354686 | ||||||||
| Practice Location | |||||||||
| Address1: | 3840 HULEN ST STE 602 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761077275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177354165 | ||||||||
| FaxNumber: | 8177354686 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 003428 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.