Guadalupe Crawford, LAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Grand Forks, ND

NPI 1386860286 · NPPES record last updated Oct 22, 2014

Key facts

NPI
1386860286
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1557 (ND)
Practice address
151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715
Phone
(701) 795-3000
Fax
(701) 795-3050
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1557 ND Yes

Addresses

Primary practice location

151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715

Mailing address

151 S 4TH St
Suite 401
Grand Forks, ND 58201-4715
Phone (701) 795-3000

Other identifiers

IdentifierTypeStateIssuer
28140OtherNDBCBS OF ND PIN
054519MedicaidND

Other providers in Grand Forks, ND

All providers in Grand Forks, ND · Addiction (Substance Use Disorder) Counselor in North Dakota

Sources for this page

Verify at the official NPI Registry.