Provider Demographics
NPI:1285854554
Name:CRAWLEY, VERONICA (LPC, NCC, LCAS-P)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:LPC, NCC, LCAS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 HIGH ORCHARD ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-8229
Mailing Address - Country:US
Mailing Address - Phone:910-770-1686
Mailing Address - Fax:
Practice Address - Street 1:721-A DAVIS AVENUE
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-6002
Practice Address - Country:US
Practice Address - Phone:910-207-3559
Practice Address - Fax:910-642-8831
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4720101YM0800X, 101YP2500X, 101YS0200X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103230Medicaid