Healthcare Provider Details

I. General information

NPI: 1013406875
Provider Name (Legal Business Name): ANNA CREWS BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 FABER PLACE DR STE 600
NORTH CHARLESTON SC
29405-8548
US

IV. Provider business mailing address

PO BOX 931142
ATLANTA GA
31193-1142
US

V. Phone/Fax

Practice location:
  • Phone: 843-352-7049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-16798
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number18-50714
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: