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NPI Code Detail

MEDICARE: COURTNEY CRAWFORD

MEDICARE: COURTNEY CRAWFORD
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
11041C0700XClinical Social WorkerP008794NC

General Provider Information

NPI Number : 1689086431
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY CRAWFORD
Provider Business Mailing Address
First Line : 136 E CHAPEL HILL ST
Second Line :
City : DURHAM
State : NC
Zip : 27701-3202
Country : US
Telephone Number : 919-688-7101
Fax Number :
Provider Business Practice Location Address
First Line : 2020 CHAPEL HILL RD STE 23
Second Line :
City : DURHAM
State : NC
Zip : 27707-1186
Country : US
Telephone Number : 919-688-7101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2014
Last Update Date : 08/13/2020

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