| Christa L Crawford Lcsw Pc | |
|
2914 N Oak St Valdosta GA 31602-1718 | |
| (229) 333-0300 | |
| (229) 333-0306 |
| Full Name | Christa L Crawford Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 2914 N Oak St, Valdosta, Georgia |
| Authorized Official Name and Position | Christa L Crawford (CEO) |
| Authorized Official Contact | 2292924103 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christa L Crawford Lcsw Pc 3012 Asbury Cir Valdosta GA 31602-1455 Ph: (229) 292-4103 | Christa L Crawford Lcsw Pc 2914 N Oak St Valdosta GA 31602-1718 Ph: (229) 333-0300 |
| NPI Number | 1841555745 |
|---|---|
| Provider Enumeration Date | 07/08/2012 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Medicare PECOS PAC ID | 5799936860 |
|---|---|
| Medicare Enrollment ID | O20121119000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841555745 | NPI | - | NPPES |
| 565665116A | Medicaid | GA | |
| 12092174 | Other | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003454 (Georgia) | Primary |
| Provider Name | Christa L Crawford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275726184 PECOS PAC ID: 0547290579 Enrollment ID: I20050818000625 |
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