Provider Demographics
NPI:1538880034
Name:CRAWFORD, ADINA CHANTA (LCSW)
Entity type:Individual
Prefix:
First Name:ADINA
Middle Name:CHANTA
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 1:190 LAGUNA WAY
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-0003
Mailing Address - Country:US
Mailing Address - Phone:912-484-6299
Mailing Address - Fax:
Practice Address - Street 1:836 E 65TH ST STE 44
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4496
Practice Address - Country:US
Practice Address - Phone:912-660-6061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0082251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical