Provider Demographics
NPI:1982975413
Name:CRAWFORD, MINNIE JOYCE (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MINNIE
Middle Name:JOYCE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HIGHWAY 921
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:LA
Mailing Address - Zip Code:71326-4701
Mailing Address - Country:US
Mailing Address - Phone:318-389-6722
Mailing Address - Fax:318-389-6722
Practice Address - Street 1:100 N HICKORY ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3315
Practice Address - Country:US
Practice Address - Phone:318-372-3134
Practice Address - Fax:318-336-7112
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2542101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional