Provider Demographics
NPI:1932580628
Name:CRAWFORD, CHRISTY GAIL (LAC, CRC)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:GAIL
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LAC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MONT BLANC COVE
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113
Mailing Address - Country:US
Mailing Address - Phone:501-257-2120
Mailing Address - Fax:
Practice Address - Street 1:10025 W MARKHAM ST STE 210
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2178
Practice Address - Country:US
Practice Address - Phone:501-663-5473
Practice Address - Fax:501-661-1812
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2403001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional