Provider Demographics
NPI:1679937486
Name:CRAW, AMANDA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CRAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:CRAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PLMHP
Mailing Address - Street 1:124 S 24TH ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1226
Mailing Address - Country:US
Mailing Address - Phone:402-292-9105
Mailing Address - Fax:402-591-5075
Practice Address - Street 1:11515 S 39TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-5200
Practice Address - Country:US
Practice Address - Phone:402-292-9105
Practice Address - Fax:402-591-5075
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health