Organization
EMOTIONAL ABUSE SUPPORT TEAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMAREST CRAWL LCSW-C (EXECUTIVE)
(240) 319-0182
Entity
Organization
Contact information
Practice address
1808 61ST AVE, CHEVERLY, MD 20785-3803
(240) 319-0182
Mailing address
1808 61ST AVE, CHEVERLY, MD 20785-3803
(240) 319-0182
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023663325
NPI
MD
01
—
1205355344
NPI
MD
05
—
822045000
—
MD
Enumeration date
02/03/2021
Last updated
02/03/2021
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