Basic Information
| Provider Information | |||||||||
| NPI: | 1265782403 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CRAWFORD UNIT LLC | ||||||||
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| OtherOrganizationName: | THE CRAWFORD UNIT LLC | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 905 US HIGHWAY 321 NW # 326 | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286014745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284559031 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 HARRILSON RD | ||||||||
| Address2: | |||||||||
| City: | CHERRYVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280219541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044354161 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2012 | ||||||||
| LastUpdateDate: | 09/14/2012 | ||||||||
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| AuthorizedOfficialLastName: | CRAWFORD | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
| AuthorizedOfficialMiddleName: | FISH | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8284559031 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | APMHNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | NC | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.