Provider Demographics
NPI:1831668680
Name:CRAWFORD, TRUDIE GAY (LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:TRUDIE
Middle Name:GAY
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-0552
Mailing Address - Country:US
Mailing Address - Phone:704-842-2262
Mailing Address - Fax:
Practice Address - Street 1:4985 GRASSY CREEK RD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-6704
Practice Address - Country:US
Practice Address - Phone:704-842-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13778101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor