Provider Demographics
NPI:1356130512
Name:CRAWFORD, KATELYN
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 LYTLE RD
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30741-4946
Mailing Address - Country:US
Mailing Address - Phone:423-255-0583
Mailing Address - Fax:
Practice Address - Street 1:141 LYTLE RD
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30741-4946
Practice Address - Country:US
Practice Address - Phone:423-255-0583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health