MEDICARE: CRYSTAL MOBLEY 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
1	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	254424	KY

General Provider Information

NPI Number	:	1568612414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL MOBLEY LCSW

Provider Business Mailing Address
First Line	:	3313 LEXINGTON RD
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-9524
Country	:	US
Telephone Number	:	859-953-1006
Fax Number	:	859-762-1695

Provider Business Practice Location Address
First Line	:	3313 LEXINGTON RD
Second Line	:
City	:	WINCHESTER
State	:	KY
Zip	:	40391-9524
Country	:	US
Telephone Number	:	859-953-1006
Fax Number	:	859-762-1695

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	12/27/2025

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Directions to “ CRYSTAL MOBLEY LCSW” Practice Location

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