Individual provider Active NPI

Marie Eileen Crawford, PHD

  • Counselor
  • Bristol, TN
National Provider Identifier
1194818096
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC1757 Issued in TN
Practice address
739 Bluff City Hwy
Suite 5
Bristol, TN 37620-4637
Phone
(423) 217-1097
Fax
(423) 217-1069
NPI assigned
Oct 2, 2006
Last updated
Feb 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC1757 TN Primary
Counselor 101Y00000X LMHC2593 FL

Addresses

Primary practice location

739 Bluff City Hwy
Suite 5
Bristol, TN 37620-4637

Mailing address

739 Bluff City Hwy
Suite 5
Bristol, TN 37620-4637
Phone (423) 217-1097

Other identifiers 2

IdentifierTypeStateIssuer
2593OtherFLLMHC
1757OtherTNLPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151229002597 TN Practitioner - Psychologist Billing Independently 5597067082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

739 Bluff City Hwy
Suite 5
Bristol, TN 37620-4637
Phone (423) 217-1097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LMHC2593FLMDCounselor
LPC1757TNMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Marie Crawford, PH.D., PLLC CurrentSince Mar 21, 2015 Accepting new patients

Locations

739 Bluff City Hwy
Ste 5
Bristol, TN 37620
Phone (423) 217-1097

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234742400000",
    "number": "1194818096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 BLUFF CITY HWY",
            "address_2": "SUITE 5",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204637",
            "telephone_number": "423-217-1097",
            "fax_number": "423-217-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 BLUFF CITY HWY",
            "address_2": "SUITE 5",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204637",
            "telephone_number": "423-217-1097",
            "fax_number": "423-217-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "MARIE",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": "LPC1757",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "LMHC2593",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "2593",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "1757",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.