Provider Demographics
NPI:1861512642
Name:CRAWFORD, PATRICK (LICSW, LCSW-C)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:LICSW, LCSW-C
Other - Prefix:MR
Other - First Name:PATRICK
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7115 CHAPPARAL DR
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1771
Mailing Address - Country:US
Mailing Address - Phone:301-341-5111
Mailing Address - Fax:
Practice Address - Street 1:829 BRIGHT SEAT ROAD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-368-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780621041C0700X
MD125901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02752C01Medicare PIN