Provider Demographics
NPI:1407298870
Name:CRAWFORD, NICOLE OLIVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:OLIVIA
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 1:7543 CRANES CREEK CT
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-8709
Mailing Address - Country:US
Mailing Address - Phone:407-808-0355
Mailing Address - Fax:
Practice Address - Street 1:7543 CRANES CREEK CT
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-8709
Practice Address - Country:US
Practice Address - Phone:813-922-5289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW113041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHN633ZMedicare PIN