Provider Demographics
NPI:1700284411
Name:CRAWFORD, LAYCEE (LSW)
Entity Type:Individual
Prefix:
First Name:LAYCEE
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 1:309 MILLIONAIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MOTT
Mailing Address - State:ND
Mailing Address - Zip Code:58646-7267
Mailing Address - Country:US
Mailing Address - Phone:701-824-3276
Mailing Address - Fax:701-824-2820
Practice Address - Street 1:309 MILLIONAIRE AVE
Practice Address - Street 2:
Practice Address - City:MOTT
Practice Address - State:ND
Practice Address - Zip Code:58646-7267
Practice Address - Country:US
Practice Address - Phone:701-824-3276
Practice Address - Fax:701-824-2820
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4958104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker