Christa L Crawford LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003454 Issued in GA

Legal business name

CHRISTA L CRAWFORD LCSW PC

Practice address

2914 N Oak St
Valdosta, GA 31602-1718

Phone

(229) 333-0300

Fax

(229) 333-0306

NPI assigned

Jul 8, 2012

Organization subpart

No

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

Authorized official

Name

Christa L Crawford, LCSWNPI 1275726184

Title

Ceo

Phone

(229) 292-4103

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christa Lynn Crawford, L.C.S.W.

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1275726184
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1341705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1841555745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 ASBURY CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021455",
            "telephone_number": "229-292-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021718",
            "telephone_number": "229-333-0300",
            "fax_number": "229-333-0306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 Noble Way",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316057410",
            "country_code": "US",
            "telephone_number": "229-292-4103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHRISTA L CRAWFORD LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-08",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "CHRISTA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-292-4103",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "565665116A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12092174",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mike Syru Chiang, M.D.
• Ven Chung Chiang, MD
• Mi Hyun Choi, FNP-C
• Choice Family Medicine, PC
• Choices for Life of Georgia, LLC
• Jennetta M Christie, M.D.
• Hunter L Clanton, FNP-C
• Ashlyn Clark
• Keyiarra Clark
• Kristine Julia Clark, OTD, OTR/L

• Clinical Social Worker in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.