Provider Demographics
NPI:1538551007
Name:CRAWFORD, MARY (LPC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 GALLION RD
Mailing Address - Street 2:
Mailing Address - City:GALLION
Mailing Address - State:AL
Mailing Address - Zip Code:36742-4820
Mailing Address - Country:US
Mailing Address - Phone:256-338-5498
Mailing Address - Fax:
Practice Address - Street 1:267 GALLION RD
Practice Address - Street 2:
Practice Address - City:GALLION
Practice Address - State:AL
Practice Address - Zip Code:36742-4820
Practice Address - Country:US
Practice Address - Phone:256-338-5498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional