Provider Demographics
NPI:1043217029
Name:CROSBY, ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:CROSBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 142
Mailing Address - Street 2:
Mailing Address - City:EASTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40018-0142
Mailing Address - Country:US
Mailing Address - Phone:502-345-1520
Mailing Address - Fax:502-244-6994
Practice Address - Street 1:173 SEARS AVE
Practice Address - Street 2:STE 269
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-5059
Practice Address - Country:US
Practice Address - Phone:502-345-1520
Practice Address - Fax:502-244-6994
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2009-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY291104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1043217029Medicare NSC