Provider Demographics
NPI:1487947230
Name:CRAWFORD, LONNIE THOMAS (BS)
Entity type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:THOMAS
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:BS
Other - Prefix:MR
Other - First Name:LONNIE
Other - Middle Name:THOMAS
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS
Mailing Address - Street 1:7816 BOW CT
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6312
Mailing Address - Country:US
Mailing Address - Phone:972-333-4489
Mailing Address - Fax:
Practice Address - Street 1:7816 BOW CT
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-6312
Practice Address - Country:US
Practice Address - Phone:972-333-4489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health