Provider Demographics
NPI:1811624281
Name:CRAWFORD COUNSELING AND WELLNESS
Entity type:Organization
Organization Name:CRAWFORD COUNSELING AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINE
Authorized Official - Middle Name:RAINEY
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LMHC
Authorized Official - Phone:904-557-5288
Mailing Address - Street 1:130 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32034-2544
Mailing Address - Country:US
Mailing Address - Phone:904-557-5288
Mailing Address - Fax:
Practice Address - Street 1:501 CENTRE ST STE 117
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-3936
Practice Address - Country:US
Practice Address - Phone:904-557-5288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty