MEDICARE: MR. MATTHEW ARTHUR CRAWFORD LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1386932036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW ARTHUR CRAWFORD LPC

Provider Business Mailing Address
First Line	:	28055 E 150TH ST S
Second Line	:
City	:	COWETA
State	:	OK
Zip	:	74429-6775
Country	:	US
Telephone Number	:	918-810-6687
Fax Number	:

Provider Business Practice Location Address
First Line	:	6128 E 38TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-5832
Country	:	US
Telephone Number	:	918-779-7144
Fax Number	:	405-259-5924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2011
Last Update Date	:	08/19/2024

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