Active NPI
Malissa Truesdale-Crawford, LPC
- Mental Health Counselor
- Waxhaw, NC
National Provider Identifier
1598433807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 9097
- Practice address
- 104 Waxhaw Professional Park Dr Ste D
Waxhaw, NC 28173-5020 - Phone
- (980) 368-0323
- NPI assigned
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A17097 | NC | |
| Mental Health Counselor | 101YM0800X | 9097 | SC | Primary |
Addresses
Primary practice location
104 Waxhaw Professional Park Dr Ste D
Waxhaw, NC 28173-5020
Mailing address
4251 S Rhett Ave Unit 5207
North Charleston, SC 29405-6911
Phone (803) 804-5199
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A17097 | NC | MD | Mental Health Counselor |
| 9097 | SC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| True Mental Wellness Counseling & Consulting | Mental Health | Current | Accepting new patients |
| Thrive Family Services | Mental Health | Past | Accepting new patients |
Locations
104 Waxhaw Professional Park Dr
Ste D
Waxhaw, NC 28173
Phone (704) 748-0735
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Waxhaw, NC
- NPI 1437936101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698796800000",
"number": "1598433807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4251 S RHETT AVE UNIT 5207",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294056911",
"telephone_number": "803-804-5199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 WAXHAW PROFESSIONAL PARK DR STE D",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281735020",
"telephone_number": "980-368-0323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUESDALE-CRAWFORD",
"first_name": "MALISSA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-01",
"last_updated": "2023-11-01",
"certification_date": "2023-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A17097",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "SC",
"license": "9097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waxhaw, NC
- Ashley Morgan Tomanelli, PT, DPT
- Paige Emily Tomcho, DO
- Lisa Anne Toroni
- Transformations Health Services LLC
- True Mental Wellness Counseling & Consulting
- Ashley Elizabeth Turman, PT
- Mary Catherine Turner, LCSW, LISW-CP
- Tania Ungerer, DNP
- Union Physicians Network Inc (Union Surgical Associates)
- Union Physicians Network Inc (Union Pulmonary & Sleep Specialists)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.