Provider Demographics
NPI:1124189774
Name:CRAWFORD, GINNY (MSW, CSW-PIP)
Entity Type:Individual
Prefix:
First Name:GINNY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MSW, CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W 5TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CANTON
Mailing Address - State:SD
Mailing Address - Zip Code:57013-1534
Mailing Address - Country:US
Mailing Address - Phone:605-558-2000
Mailing Address - Fax:605-558-1999
Practice Address - Street 1:1010 W 5TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CANTON
Practice Address - State:SD
Practice Address - Zip Code:57013-1534
Practice Address - Country:US
Practice Address - Phone:605-558-2000
Practice Address - Fax:605-558-1999
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD20611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN712980000Medicaid
SD6576562Medicaid
SD9258541OtherDAKOTACARE
9258541OtherDAKOTACARE
1124189774OtherWELLMARK BCBS SD
SD6576560Medicaid
SD9258541OtherDAKOTACARE