Provider Demographics
NPI:1750158846
Name:CRAWFORD, ALYSSA (LCPC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:IA
Mailing Address - Zip Code:50628-8214
Mailing Address - Country:US
Mailing Address - Phone:563-203-7687
Mailing Address - Fax:
Practice Address - Street 1:606 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:IA
Practice Address - Zip Code:50628-8214
Practice Address - Country:US
Practice Address - Phone:563-203-7687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-56874101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional