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General NPI Number Information
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NPI Number | 1215454459
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Entity Type | Organization
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Legal Business Name | CRAWFORD COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 08/28/2017
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 2182 MCCULLOCH BLVD N STE 3
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-6880
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Country | US
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Telephone | 928-600-5497
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Fax | 888-276-8290
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Provider Business Mailing Address
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Address Line | 2182 MCCULLOCH BLVD N STE 3
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-6880
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Country | US
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Telephone | 928-600-5497
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Fax | 888-276-8290
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Authorized Official
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Title or Position | CLINICAL MENTAL HEALTH COUNSELOR
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Name | MS. DELORES LEE CRAWFORD
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Credential | LPC
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Telephone | 928-600-5497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LPC-15548
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License Number State | AZ
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