Provider Demographics
NPI:1720459944
Name:ELIZABETH CRAWFORD THERAPY
Entity Type:Organization
Organization Name:ELIZABETH CRAWFORD THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:860-501-2006
Mailing Address - Street 1:1520 CAMBRIDGE ST
Mailing Address - Street 2:APT 1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1035
Mailing Address - Country:US
Mailing Address - Phone:860-501-2006
Mailing Address - Fax:
Practice Address - Street 1:1520 CAMBRIDGE ST
Practice Address - Street 2:APT 1
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1035
Practice Address - Country:US
Practice Address - Phone:860-501-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty