Healthcare Provider Details

I. General information

NPI: 1619188745
Provider Name (Legal Business Name): JAMES ROBERT CRAWFORD MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5825 US HIGHWAY 27 N
SEBRING FL
33870-1216
US

IV. Provider business mailing address

5825 US HIGHWAY 27 N
SEBRING FL
33870-1216
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-7056
  • Fax:
Mailing address:
  • Phone: 863-294-7056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 8549
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: