Basic Information
| Provider Information | |||||||||
| NPI: | 1447686076 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRAWFORD | ||||||||
| FirstName: | MATHEW | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 E PARK ROW DR | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760104426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178041551 | ||||||||
| FaxNumber: | 8172757866 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 E PARK ROW DR | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760104426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178041551 | ||||||||
| FaxNumber: | 8172757866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2013 | ||||||||
| LastUpdateDate: | 09/14/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 64506 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.