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NPI Code Detail

MEDICARE: MR. WILLIAM HOWARD CREASMAN III LCSW

MEDICARE: MR. WILLIAM HOWARD CREASMAN III 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
11041C0700XClinical Social Worker253457KY
21041C0700XClinical Social Worker256416KY

General Provider Information

NPI Number : 1013514371
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM HOWARD CREASMAN III LCSW
Provider Business Mailing Address
First Line : 10401 LINN STATION RD STE 100
Second Line :
City : LOUISVILLE
State : KY
Zip : 40223-3842
Country : US
Telephone Number : 502-589-8600
Fax Number :
Provider Business Practice Location Address
First Line : 914 E BROADWAY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40204-1037
Country : US
Telephone Number : 502-587-8833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2020
Last Update Date : 03/26/2026

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