Provider Demographics
NPI:1619021581
Name:CREW, CANDACE CORINNE (LCSW-C)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:CORINNE
Last Name:CREW
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NORTH AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2314
Mailing Address - Country:US
Mailing Address - Phone:410-420-7292
Mailing Address - Fax:410-420-7276
Practice Address - Street 1:4 NORTH AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2314
Practice Address - Country:US
Practice Address - Phone:410-420-7292
Practice Address - Fax:410-420-7276
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD138231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical