Provider Demographics
NPI:1912686734
Name:SELF-AWARENESS & DISCOVERY
Entity Type:Organization
Organization Name:SELF-AWARENESS & DISCOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-818-9168
Mailing Address - Street 1:3014 BLUESTEM RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4118
Mailing Address - Country:US
Mailing Address - Phone:303-818-9168
Mailing Address - Fax:
Practice Address - Street 1:3014 BLUESTEM RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-4118
Practice Address - Country:US
Practice Address - Phone:303-818-9168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty