Provider Demographics
NPI:1376914630
Name:CRENSHAW, MEAGAN KEELY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEAGAN
Middle Name:KEELY
Last Name:CRENSHAW
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 1:350 SALEM RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6166
Mailing Address - Country:US
Mailing Address - Phone:501-336-8300
Mailing Address - Fax:
Practice Address - Street 1:350 SALEM RD STE 1
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-6166
Practice Address - Country:US
Practice Address - Phone:501-336-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8380-M104100000X
AR8380-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker