Healthcare Provider Details

I. General information

NPI: 1568091726
Provider Name (Legal Business Name): DARA DOMINIQUE CRAWLEY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 ELKRIDGE LANDING RD STE 350
LINTHICUM HEIGHTS MD
21090-2953
US

IV. Provider business mailing address

939 ELKRIDGE LANDING RD STE 350
LINTHICUM HEIGHTS MD
21090-2953
US

V. Phone/Fax

Practice location:
  • Phone: 443-354-8903
  • Fax:
Mailing address:
  • Phone: 443-354-8903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number25815
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: