Individual provider Active NPI

Ieesha Crawford, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1083364152
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15240 Issued in FL
Practice address
1005 W State Road 84
Fort Lauderdale, FL 33315-2433
Phone
(754) 900-8280
Fax
(949) 862-3411
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW15240 FL Primary

Addresses

Primary practice location

1005 W State Road 84
Fort Lauderdale, FL 33315-2433

Mailing address

1130 SW 7TH Ave
Deerfield Beach, FL 33441-6319
Phone (954) 803-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240517000086 FL Practitioner - Clinical Social Worker 9032550389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grateful Guidance LLC CurrentSince Mar 27, 2022 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 3, 2024 Accepting new patients

Locations

1005 W State Road 84
Fort Lauderdale, FL 33315
Phone (754) 900-8280

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1083364152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 SW 7TH AVE",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334416319",
            "telephone_number": "954-803-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W STATE ROAD 84",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333152433",
            "telephone_number": "754-900-8280",
            "fax_number": "949-862-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "IEESHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.