Provider Demographics
NPI:1629872411
Name:CRAWFORD, TAMALA LAVERNE (LCSW)
Entity type:Individual
Prefix:
First Name:TAMALA
Middle Name:LAVERNE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 WINTERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2651
Mailing Address - Country:US
Mailing Address - Phone:972-983-9576
Mailing Address - Fax:
Practice Address - Street 1:1501 COFFEYVILLE TRL
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-2046
Practice Address - Country:US
Practice Address - Phone:972-522-3920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX593551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical