Provider Demographics
NPI:1013760479
Name:CRAWFORD, HALEY NICOLE (MED, LPC-A)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:NICOLE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MED, LPC-A
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:NICOLE
Other - Last Name:MAINVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 SHILOH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:PAULINE
Mailing Address - State:SC
Mailing Address - Zip Code:29374-2019
Mailing Address - Country:US
Mailing Address - Phone:864-209-1818
Mailing Address - Fax:
Practice Address - Street 1:231 SHILOH CHURCH RD
Practice Address - Street 2:
Practice Address - City:PAULINE
Practice Address - State:SC
Practice Address - Zip Code:29374-2019
Practice Address - Country:US
Practice Address - Phone:864-209-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health