Provider Demographics
NPI:1659471878
Name:CRAWFORD, MELANIE BALL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:BALL
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:BALL
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1212 HOLLOW TREE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5845
Mailing Address - Country:US
Mailing Address - Phone:704-264-2130
Mailing Address - Fax:
Practice Address - Street 1:5208 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3646
Practice Address - Country:US
Practice Address - Phone:704-529-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0045371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical