Provider Demographics
NPI:1275769903
Name:CRAWFORD, TAMMY (LPC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1326
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75671-1326
Mailing Address - Country:US
Mailing Address - Phone:903-927-3782
Mailing Address - Fax:903-927-1764
Practice Address - Street 1:4077 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854
Practice Address - Country:US
Practice Address - Phone:870-330-9200
Practice Address - Fax:870-330-9439
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ARP1402013101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP1402013OtherAR BOARD OF NURSING