Individual provider Active NPI

Russell Crawford, PHD, LPC, NCC

  • Professional Counselor
  • Virginia Beach, VA
National Provider Identifier
1366822942
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701006115 Issued in VA
Practice address
780 Lynnhaven Pkwy Ste 340
Virginia Beach, VA 23452-7361
Phone
(757) 694-4723
Fax
(757) 301-8803
NPI assigned
Jun 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701006115 VA Primary

Addresses

Primary practice location

780 Lynnhaven Pkwy Ste 340
Virginia Beach, VA 23452-7361

Mailing address

780 Lynnhaven Pkwy Ste 340
Virginia Beach, VA 23452-7361
Phone (757) 694-4723

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0701006115VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1366822942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY STE 340",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527361",
            "telephone_number": "757-694-4723",
            "fax_number": "757-301-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY STE 340",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527361",
            "telephone_number": "757-694-4723",
            "fax_number": "757-301-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.