Provider Demographics
NPI:1902093917
Name:CRAWFORD, LELAND LOUIS (BA LACSAP)
Entity type:Individual
Prefix:MR
First Name:LELAND
Middle Name:LOUIS
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:BA LACSAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2255
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-2255
Mailing Address - Country:US
Mailing Address - Phone:406-217-2009
Mailing Address - Fax:406-338-2304
Practice Address - Street 1:131 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417
Practice Address - Country:US
Practice Address - Phone:406-217-2009
Practice Address - Fax:406-338-2304
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1062101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)