Provider Demographics
NPI:1265145544
Name:CRAWFORD, AMBER LOVE (LPC-A)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LOVE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 MOONSTONE DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-2966
Mailing Address - Country:US
Mailing Address - Phone:512-903-9248
Mailing Address - Fax:
Practice Address - Street 1:100 W CENTRAL TEXAS EXPY STE 200C
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2079
Practice Address - Country:US
Practice Address - Phone:432-693-4661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90455101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty