Provider Demographics
NPI:1265705362
Name:CRAWLEY, JENNA WILSON (LPC, LCAS)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:WILSON
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 SLEEPY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-9703
Mailing Address - Country:US
Mailing Address - Phone:828-260-6418
Mailing Address - Fax:
Practice Address - Street 1:805 STATE FARM RD
Practice Address - Street 2:304
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4914
Practice Address - Country:US
Practice Address - Phone:828-260-6419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor