Provider Demographics
NPI:1144221284
Name:CRAWFORD, JILL (LCSW)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
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 1:101 DENNIS LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4730
Mailing Address - Country:US
Mailing Address - Phone:610-933-9092
Mailing Address - Fax:
Practice Address - Street 1:617B SWEDESFORD RD
Practice Address - Street 2:SWEDESFORD CORPORATE CENTER
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1530
Practice Address - Country:US
Practice Address - Phone:610-564-6835
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0146691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical