Provider Demographics
NPI:1619246238
Name:CRUMPLER, LATRESHA ARTIS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LATRESHA
Middle Name:ARTIS
Last Name:CRUMPLER
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:1202 E. FIRETOWER ROAD
Mailing Address - Street 2:PATHWAYS TO LIFE, INC.
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4196
Mailing Address - Country:US
Mailing Address - Phone:252-695-0269
Mailing Address - Fax:252-413-0526
Practice Address - Street 1:1329 N. BRIGHTLEAF BLVD., SUITE A-1
Practice Address - Street 2:PATHWAYS TO LIFE, INC.
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-7262
Practice Address - Country:US
Practice Address - Phone:919-938-0442
Practice Address - Fax:919-938-0448
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCP006802104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker