Healthcare Provider Details

I. General information

NPI: 1528653490
Provider Name (Legal Business Name): ASHTON E CRISPIN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2021
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 NW W HWY
KINGSVILLE MO
64061-9117
US

IV. Provider business mailing address

1022 NE COLUMBUS ST
LEES SUMMIT MO
64086-3016
US

V. Phone/Fax

Practice location:
  • Phone: 816-419-8489
  • Fax:
Mailing address:
  • Phone: 816-419-8489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: