MEDICARE: NANCY CRUTE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C006768	NC

General Provider Information

NPI Number	:	1104143569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY CRUTE LCSW

Provider Business Mailing Address
First Line	:	102 GOLDSTON AVE
Second Line	:
City	:	CARRBORO
State	:	NC
Zip	:	27510-1214
Country	:	US
Telephone Number	:	919-357-3505
Fax Number	:

Provider Business Practice Location Address
First Line	:	307 N COLUMBIA ST
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-2119
Country	:	US
Telephone Number	:	919-357-3505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2010
Last Update Date	:	06/26/2013

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