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General NPI Number Information
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NPI Number | 1083155402
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Entity Type | Individual
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Provider Name | AMBROSIA LEE CRUMP LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 3690 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89169-3300
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Country | US
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Telephone | 702-756-9247
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Fax | 877-917-9818
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Provider Business Mailing Address
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Address Line | PO BOX 60066
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City | LAS VEGAS
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State | NV
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Zip | 89160-0066
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Country | US
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Telephone | 702-567-9247
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Fax | 877-917-9818
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8797-C
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License Number State | NV
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