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NPI Code Detail

MEDICARE: SHAWANDA ANN CRAWFORD LMFT

MEDICARE: SHAWANDA ANN CRAWFORD LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorAMFT110125CA
2106H00000XMarriage & Family Therapist73538CA
3106H00000XMarriage & Family TherapistAMFT110125CA
4106H00000XMarriage & Family Therapist116389CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
173538OTHERCABOARD OF BEHAVIORAL SCIENCES

General Provider Information

NPI Number : 1235256710
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWANDA ANN CRAWFORD LMFT
Provider Business Mailing Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number :
Provider Business Practice Location Address
First Line : 470 E 3RD ST STE C
Second Line :
City : LOS ANGELES
State : CA
Zip : 90013-1630
Country : US
Telephone Number : 213-620-5712
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 06/30/2022

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Directions to “ SHAWANDA ANN CRAWFORD LMFT” Practice Location

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