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NPI Code Detail

MEDICARE: NICOLE S CRENSHAW LCSW

MEDICARE: NICOLE S CRENSHAW 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
1104100000XSocial WorkerKY-5305KY
21041C0700XClinical Social Worker253979KY

General Provider Information

NPI Number : 1255516787
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE S CRENSHAW LCSW
Provider Business Mailing Address
First Line : 5658 E PRIDDY RD
Second Line :
City : PEKIN
State : IN
Zip : 47165-7612
Country : US
Telephone Number : 502-653-0721
Fax Number :
Provider Business Practice Location Address
First Line : 2301 GOLDSMITH LN
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-1018
Country : US
Telephone Number : 502-458-1171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 05/11/2026

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Directions to “ NICOLE S CRENSHAW LCSW” Practice Location

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