Provider Demographics
NPI:1346329265
Name:CRAWFORD, BRADLEY (PSYD LPC)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PSYD LPC
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 9400
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-9400
Mailing Address - Country:US
Mailing Address - Phone:480-368-2827
Mailing Address - Fax:
Practice Address - Street 1:1615 E WARNER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-4500
Practice Address - Country:US
Practice Address - Phone:480-368-2827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 2366101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health