Provider Demographics
NPI:1336931567
Name:MCCAWLEY, CRYSTAL (PRSS)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:MCCAWLEY
Suffix:
Gender:F
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-4083
Mailing Address - Country:US
Mailing Address - Phone:304-217-3019
Mailing Address - Fax:
Practice Address - Street 1:353 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4083
Practice Address - Country:US
Practice Address - Phone:304-217-3019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator