Provider Demographics
NPI:1922410091
Name:CRAWFORD, JOHNATHAN MARSHALL (LPC)
Entity type:Individual
Prefix:
First Name:JOHNATHAN
Middle Name:MARSHALL
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 GARRISONVILLE RD STE 116
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-8900
Mailing Address - Country:US
Mailing Address - Phone:540-782-8878
Mailing Address - Fax:866-463-1099
Practice Address - Street 1:9097 ATLEE STATION RD STE 318
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2527
Practice Address - Country:US
Practice Address - Phone:804-834-7989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1528091063Medicaid