Healthcare Provider Details

I. General information

NPI: 1053972265
Provider Name (Legal Business Name): MELISSA CRAWFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N MAIN ST # 304
CROWN POINT IN
46307-1877
US

IV. Provider business mailing address

6239 KERF LN
NOBLESVILLE IN
46062-6470
US

V. Phone/Fax

Practice location:
  • Phone: 574-546-1900
  • Fax: 574-546-1999
Mailing address:
  • Phone: 317-966-7126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34005549A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: