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General NPI Number Information
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NPI Number | 1316909617
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Entity Type | Individual
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Provider Name | PERRY NEAL CRAWFORD PHD, LPC, LADC, NCC
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Gender | Male
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | ARMY SUBSTANCE ABUSE PROGRAM CLINIC MARY E. WALKER CENTER
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City | FORT IRWIN
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State | CA
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Zip | 92310-5090
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Country | US
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Telephone | 760-380-4044
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Fax | 760-380-6469
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Provider Business Mailing Address
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Address Line | 1117 TETON DR
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City | BARSTOW
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State | CA
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Zip | 92311-6706
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Country | US
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Telephone | 760-380-4044
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Fax | 760-380-6469
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | COUN 306
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 588
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License Number State | NV
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