Organization
CHRISTA L CRAWFORD LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTA L CRAWFORD LCSW (CEO)
(229) 292-4103
Entity
Organization
Contact information
Practice address
2914 N OAK ST, VALDOSTA, GA 31602-1718
(229) 333-0300
(229) 333-0306
Mailing address
3012 ASBURY CIR, VALDOSTA, GA 31602-1455
(229) 292-4103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003454
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12092174
CAQH
—
05
—
565665116A
—
GA
Enumeration date
07/08/2012
Last updated
07/15/2020
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