Provider Demographics
NPI:1386048940
Name:CRAWFORD COUNSELING CENTER
Entity type:Organization
Organization Name:CRAWFORD COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CSW-PIP
Authorized Official - Phone:605-558-2000
Mailing Address - Street 1:1010 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:SD
Mailing Address - Zip Code:57013-1534
Mailing Address - Country:US
Mailing Address - Phone:605-558-2000
Mailing Address - Fax:605-558-1999
Practice Address - Street 1:1010 W 5TH ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:SD
Practice Address - Zip Code:57013-1534
Practice Address - Country:US
Practice Address - Phone:605-558-2000
Practice Address - Fax:605-558-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6576562Medicaid
SD40406Medicare PIN