Active NPI
Walter Lee Crawford, LPC
- Professional Counselor
- Jonesboro, AR
National Provider Identifier
1376586297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P9401004
- Practice address
- 1815 Pleasant Grove Rd
Jonesboro, AR 72401 - Phone
- (870) 933-6886
- Fax
- (870) 933-9395
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | AR | ||
| Professional Counselor | 101YP2500X | P9401004 | AR | Primary |
Addresses
Primary practice location
1815 Pleasant Grove Rd
Jonesboro, AR 72401
Mailing address
1815 Pleasant Grove Rd
Jonesboro, AR 72401-7870
Phone (870) 933-6886
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5X977 | Other | AR | BCBS |
| 169856795 | Medicaid | AR | |
| 5X977 | Other | AR | BLUE CROSS NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P9401004 | AR | MD | Psychiatric/Mental Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Families, Inc of Arkansas | Mental Health | Current | Accepting new patients |
Locations
1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886
1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303
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 and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Jonesboro, AR
- NPI 1770535569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1376586297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724017870",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1815 PLEASANT GROVE RD",
"city": "JONESBORO",
"state": "AR",
"postal_code": "72401",
"telephone_number": "870-933-6886",
"fax_number": "870-933-9395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAWFORD",
"first_name": "WALTER",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P9401004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5X977",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169856795",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS NUMBER",
"identifier": "5X977",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.