Provider Demographics
NPI:1013796382
Name:CRAWFORD, CARMEN (LSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E HAWTHORN PKWY STE 325
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1460
Mailing Address - Country:US
Mailing Address - Phone:224-424-0432
Mailing Address - Fax:
Practice Address - Street 1:175 E HAWTHORN PKWY STE 325
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1460
Practice Address - Country:US
Practice Address - Phone:224-424-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.111549104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker