Provider Demographics
NPI:1376130815
Name:CRAWFORD, PAULA L (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:L
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 RIDGE AVE STE 116
Mailing Address - Street 2:BOX 308
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1601
Mailing Address - Country:US
Mailing Address - Phone:484-429-9360
Mailing Address - Fax:
Practice Address - Street 1:6060 RIDGE AVE STE 200
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1658
Practice Address - Country:US
Practice Address - Phone:267-602-1297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007574101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional