Provider Demographics
NPI:1689313280
Name:CRAWFORD, AMY L (LCSW)
Entity type:Individual
Prefix:MISS
First Name:AMY
Middle Name:L
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MEDICAL CENTER DR STE 2700
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2669
Mailing Address - Country:US
Mailing Address - Phone:207-721-8700
Mailing Address - Fax:207-536-6719
Practice Address - Street 1:121 MEDICAL CENTER DR STE 2700
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2669
Practice Address - Country:US
Practice Address - Phone:207-721-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC233361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME20404OtherSTATE OF MAINE - MASTER SOCIAL WORKER - CONDITIONAL CLINICAL LICENSE