Healthcare Provider Details

I. General information

NPI: 1205204906
Provider Name (Legal Business Name): ROSEMARIE CRENSHAW LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSEMARIE PROCOPIO

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1572 CITRUS MEDICAL CT
OCOEE FL
34761-4547
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05757400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW18362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: