Provider Demographics
NPI:1326167727
Name:CRAWFORD, JEAN A (LPC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:A
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E 32ND ST
Mailing Address - Street 2:APT 1200
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4054
Mailing Address - Country:US
Mailing Address - Phone:312-225-2255
Mailing Address - Fax:
Practice Address - Street 1:601 E 32ND ST
Practice Address - Street 2:APT 1200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4054
Practice Address - Country:US
Practice Address - Phone:312-225-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health