Healthcare Provider Details

I. General information

NPI: 1821925488
Provider Name (Legal Business Name): AMANDA LYNN CRAWFORD LICSW, LCSWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CROSS RIDGE CT
GERMANTOWN MD
20874-1508
US

IV. Provider business mailing address

30 CROSS RIDGE CT
GERMANTOWN MD
20874-1508
US

V. Phone/Fax

Practice location:
  • Phone: 443-366-1681
  • Fax: 443-366-1681
Mailing address:
  • Phone: 443-366-1681
  • Fax: 443-366-1681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200003042
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: