MEDICARE: CHRISTY R CRAWFORD MA, LPC

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
1	101YP2500X	Professional Counselor	2016044485	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710497821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY R CRAWFORD MA, LPC

Provider Business Mailing Address
First Line	:	1300 E BRADFORD PKWY
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-4264
Country	:	US
Telephone Number	:	417-761-5000
Fax Number	:	417-761-5011

Provider Business Practice Location Address
First Line	:	305 N MASON ST
Second Line	:
City	:	CARROLLTON
State	:	MO
Zip	:	64633-2247
Country	:	US
Telephone Number	:	660-542-1403
Fax Number	:	660-542-3141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2017
Last Update Date	:	04/08/2021

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