Provider Demographics
NPI:1083155402
Name:CRUMP, AMBROSIA LEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMBROSIA
Middle Name:LEE
Last Name:CRUMP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6935 ALIANTE PKWY STE 104-172
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-5818
Mailing Address - Country:US
Mailing Address - Phone:702-581-1825
Mailing Address - Fax:877-917-9818
Practice Address - Street 1:6935 ALIANTE PKWY STE 104-172
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-5818
Practice Address - Country:US
Practice Address - Phone:702-756-9247
Practice Address - Fax:877-917-9818
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV8797-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical