Provider Demographics
NPI:1801080403
Name:CRAWFORD, KATHLEEN F (LCPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:F
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 1:12739 CUNNINGHILL COVE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-1176
Mailing Address - Country:US
Mailing Address - Phone:410-627-7450
Mailing Address - Fax:
Practice Address - Street 1:12739 CUNNINGHILL COVE RD
Practice Address - Street 2:
Practice Address - City:MIDDLE RIVER
Practice Address - State:MD
Practice Address - Zip Code:21220-1176
Practice Address - Country:US
Practice Address - Phone:410-627-7450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2376101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health