Provider Demographics
NPI:1174021208
Name:CRAWFORD, LOYCE LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:LOYCE
Middle Name:LEE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:OROFINO
Mailing Address - State:ID
Mailing Address - Zip Code:83544-1124
Mailing Address - Country:US
Mailing Address - Phone:208-476-7483
Mailing Address - Fax:208-476-3144
Practice Address - Street 1:205 107TH ST
Practice Address - Street 2:
Practice Address - City:OROFINO
Practice Address - State:ID
Practice Address - Zip Code:83544-9381
Practice Address - Country:US
Practice Address - Phone:208-476-7483
Practice Address - Fax:208-476-3144
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILLCSW-266311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical