Provider Demographics
NPI:1861518078
Name:CRAWFORD, JEAN BARNES (LPC LMFT)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:BARNES
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:CRAWFORD
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC LMFT
Mailing Address - Street 1:640 INDEPENDENCE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-5205
Mailing Address - Country:US
Mailing Address - Phone:757-420-0530
Mailing Address - Fax:757-420-0488
Practice Address - Street 1:640 INDEPENDENCE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-5205
Practice Address - Country:US
Practice Address - Phone:757-420-0530
Practice Address - Fax:757-420-0488
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000930101YP2500X
VA0717000562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist