Healthcare Provider Details

I. General information

NPI: 1639459811
Provider Name (Legal Business Name): CRAWFORD MINISTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 E. KELSO STREET
INGLEWOOD CA
90301
US

IV. Provider business mailing address

400 E. KELSO STREET
INGLEWOOD CA
90301
US

V. Phone/Fax

Practice location:
  • Phone: 310-330-4700
  • Fax: 310-671-1353
Mailing address:
  • Phone: 310-330-4700
  • Fax: 310-671-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DR. BEVERLY A. CRAWFORD
Title or Position: PRESIDENT
Credential:
Phone: 310-330-4700