Provider Demographics
NPI:1205204906
Name:CRENSHAW, ROSEMARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:CRENSHAW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROSEMARIE
Other - Middle Name:
Other - Last Name:PROCOPIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7402
Mailing Address - Country:US
Mailing Address - Phone:732-693-1031
Mailing Address - Fax:732-749-1623
Practice Address - Street 1:509 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7402
Practice Address - Country:US
Practice Address - Phone:732-723-7130
Practice Address - Fax:732-276-9896
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057574001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical