Provider Demographics
NPI:1700015765
Name:CRAWFORD, KATHRYN (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NANCY LN
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1521
Mailing Address - Country:US
Mailing Address - Phone:617-286-6811
Mailing Address - Fax:
Practice Address - Street 1:20 NANCY LN
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1521
Practice Address - Country:US
Practice Address - Phone:617-286-6811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1184441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical