Provider Demographics
NPI:1851442438
Name:CRAWFORD MCCORMICK, JENNIFER F (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:F
Last Name:CRAWFORD MCCORMICK
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 IRONCLAD CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1048
Mailing Address - Country:US
Mailing Address - Phone:410-884-6031
Mailing Address - Fax:410-884-6134
Practice Address - Street 1:10440 SHAKER DR STE 208
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2339
Practice Address - Country:US
Practice Address - Phone:410-884-6031
Practice Address - Fax:410-884-6134
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDL544Medicare ID - Type Unspecified