MEDICARE: LAURA NICOLE 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	101YP2500X	Professional Counselor	PC017028	PA

General Provider Information

NPI Number	:	1891540589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA NICOLE CRAWFORD LPC

Provider Business Mailing Address
First Line	:	612 PENNSYLVANIA AVE
Second Line	:
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-1288
Country	:	US
Telephone Number	:	814-327-2006
Fax Number	:

Provider Business Practice Location Address
First Line	:	612 PENNSYLVANIA AVE
Second Line	:
City	:	HUNTINGDON
State	:	PA
Zip	:	16652-1288
Country	:	US
Telephone Number	:	814-327-2006
Fax Number	:

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

Provider Enumeration Date	:	04/17/2024
Last Update Date	:	04/17/2024

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