Healthcare Provider Details

I. General information

NPI: 1861003691
Provider Name (Legal Business Name): KIRRA CRUMP LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIRRA HAWKINS

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2172 E SPRUCE DR
CHANDLER AZ
85286-1559
US

IV. Provider business mailing address

2172 E SPRUCE DR
CHANDLER AZ
85286-1559
US

V. Phone/Fax

Practice location:
  • Phone: 801-734-9733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12830741-3501
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-22919
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: