Healthcare Provider Details

I. General information

NPI: 1407078223
Provider Name (Legal Business Name): ROBIN D CRAWLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN D FOGLE

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N SAINT ASAPH STREET
ALEXANDRIA VA
22314
US

IV. Provider business mailing address

122 AUTUNM LAKE WAY
FT WASHINGTON MD
20744
US

V. Phone/Fax

Practice location:
  • Phone: 703-838-4455
  • Fax: 703-838-5070
Mailing address:
  • Phone: 703-838-4455
  • Fax: 703-838-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904006550
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10570
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC303373
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW-011310-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: