Provider Demographics
NPI:1609274364
Name:CRAWFORD, CHERLYN NEL (LBSW)
Entity Type:Individual
Prefix:
First Name:CHERLYN
Middle Name:NEL
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23135 RADCLIFT ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2478
Mailing Address - Country:US
Mailing Address - Phone:313-733-7839
Mailing Address - Fax:
Practice Address - Street 1:23135 RADCLIFT ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2478
Practice Address - Country:US
Practice Address - Phone:313-733-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802065015104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker