Individual
T-REX CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ABD, LCAS, CSI, LCSW
Contact information
Practice address
103 ORMOND AVE, GOLDSBORO, NC 27530-4832
(919) 222-1297
(855) 329-8739
Mailing address
PO BOX 698, GOLDSBORO, NC 27533-0698
(919) 222-1297
(855) 329-8739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2011
NC
1041C0700X
Clinical Social Worker
C007765
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6007449
—
NC
Enumeration date
10/27/2009
Last updated
08/11/2012
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