Provider Demographics
NPI:1396179313
Name:CRANK, IVY ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:IVY
Middle Name:ELIZABETH
Last Name:CRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 PENISTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4630
Mailing Address - Country:US
Mailing Address - Phone:304-532-1820
Mailing Address - Fax:
Practice Address - Street 1:1141 WHITNEY AVE
Practice Address - Street 2:BUILDING #4
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-5011
Practice Address - Country:US
Practice Address - Phone:504-347-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11881104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker