Healthcare Provider Details

I. General information

NPI: 1225231806
Provider Name (Legal Business Name): JOANNA L CRAWFORD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E BURNETT ST
STAYTON OR
97383-1735
US

IV. Provider business mailing address

112 E BURNETT ST
STAYTON OR
97383-1735
US

V. Phone/Fax

Practice location:
  • Phone: 541-704-7511
  • Fax: 541-325-4082
Mailing address:
  • Phone: 541-704-7511
  • Fax: 541-325-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC8255
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: