Provider Demographics
NPI:1982263869
Name:CRAWFORD, CHRISTINE REBEKAH ALCENIUS (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:REBEKAH ALCENIUS
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 ALTAMONT ST
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-5391
Mailing Address - Country:US
Mailing Address - Phone:512-203-0849
Mailing Address - Fax:
Practice Address - Street 1:218 ALTAMONT ST
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-5391
Practice Address - Country:US
Practice Address - Phone:512-203-0849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX520591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty