Provider Demographics
NPI:1497764211
Name:CRAWFORD, CARMELA AM (LPC/RPT)
Entity Type:Individual
Prefix:MRS
First Name:CARMELA
Middle Name:AM
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC/RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S CAMERON ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4732
Mailing Address - Country:US
Mailing Address - Phone:540-722-0750
Mailing Address - Fax:540-722-0751
Practice Address - Street 1:125 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4732
Practice Address - Country:US
Practice Address - Phone:540-722-0750
Practice Address - Fax:540-722-0751
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-01-08
Deactivation Date:2018-05-02
Deactivation Code:
Reactivation Date:2020-01-08
Provider Licenses
StateLicense IDTaxonomies
VA2190101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA140690OtherANTHEM