Provider Demographics
NPI:1699468231
Name:CRAWFORD, BRYNN A (LMSW)
Entity type:Individual
Prefix:MISS
First Name:BRYNN
Middle Name:A
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 KINGSTON CT SE STE E
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8952
Mailing Address - Country:US
Mailing Address - Phone:678-304-8215
Mailing Address - Fax:
Practice Address - Street 1:2130 KINGSTON CT SE STE E
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8952
Practice Address - Country:US
Practice Address - Phone:678-304-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW011838104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker