Provider Demographics
NPI:1437856473
Name:CRAWFORD, LORRY LIN (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:LORRY
Middle Name:LIN
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:MS
Other - First Name:LORRY
Other - Middle Name:LIN
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 W BROADWAY ST STE 110
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2575
Mailing Address - Country:US
Mailing Address - Phone:989-802-4490
Mailing Address - Fax:
Practice Address - Street 1:113 W BROADWAY ST STE 110
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2575
Practice Address - Country:US
Practice Address - Phone:989-802-4490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011156971041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical