Provider Demographics
NPI:1619422722
Name:CRAWFORD, BROOKLYN CORBETT (LMFTA)
Entity Type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:CORBETT
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:BROOKLYN
Other - Middle Name:LEIGH
Other - Last Name:CORBETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFTA
Mailing Address - Street 1:1815 BRADFORD DR
Mailing Address - Street 2:APT 210
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5434
Mailing Address - Country:US
Mailing Address - Phone:507-382-4272
Mailing Address - Fax:
Practice Address - Street 1:2801 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2838
Practice Address - Country:US
Practice Address - Phone:252-636-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11067A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist