Individual provider Active NPI

T-Rex Crawford, ABD, LCAS, CSI, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Goldsboro, NC
National Provider Identifier
1992031892
Registry record updated Aug 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2011 Issued in NC
Practice address
103 Ormond Ave
Goldsboro, NC 27530-4832
Phone
(919) 222-1297
Fax
(855) 329-8739
NPI assigned
Oct 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2011 NC Primary
Clinical Social Worker 1041C0700X C007765 NC

Addresses

Primary practice location

103 Ormond Ave
Goldsboro, NC 27530-4832

Mailing address

PO Box 698
Goldsboro, NC 27533-0698
Phone (919) 222-1297

Other identifiers 1

IdentifierTypeStateIssuer
6007449MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dwi and Counseling Services, Inc. Addiction (Substance Use Disorder) CurrentSince Aug 6, 2012 Accepting new patients
Dwi and Counseling Services, Inc. Addiction (Substance Use Disorder) PastSince Aug 6, 2012 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344643200000",
    "number": "1992031892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 698",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275330698",
            "telephone_number": "919-222-1297",
            "fax_number": "855-329-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 ORMOND AVE",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304832",
            "telephone_number": "919-222-1297",
            "fax_number": "855-329-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "T-REX",
        "credential": "ABD, LCAS, CSI, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2012-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "2011",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007765",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6007449",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2012; 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.