Provider Demographics
NPI:1801056320
Name:CRAWFORD, CAMILA F (LICSW)
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:F
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CAMILA
Other - Middle Name:
Other - Last Name:SIMARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1800 ELM ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2969
Mailing Address - Country:US
Mailing Address - Phone:603-276-4005
Mailing Address - Fax:
Practice Address - Street 1:1800 ELM ST STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2969
Practice Address - Country:US
Practice Address - Phone:603-276-4005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 1041C0700X
NH24701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)