Provider Demographics
NPI:1235691551
Name:CRAWFORD, MELISSA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
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 1:1475 CHESHAM CIR
Mailing Address - Street 2:
Mailing Address - City:COLO SPGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8623
Mailing Address - Country:US
Mailing Address - Phone:571-224-8289
Mailing Address - Fax:
Practice Address - Street 1:1475 CHESHAM CIR
Practice Address - Street 2:
Practice Address - City:COLO SPGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8623
Practice Address - Country:US
Practice Address - Phone:571-224-8289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099253471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical