Provider Demographics
NPI:1689096471
Name:CROOK, ALEXIS N (LCSW, MPH, PHD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:N
Last Name:CROOK
Suffix:
Gender:F
Credentials:LCSW, MPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10219 RIVERSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5228
Mailing Address - Country:US
Mailing Address - Phone:502-322-7071
Mailing Address - Fax:
Practice Address - Street 1:4229 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3241
Practice Address - Country:US
Practice Address - Phone:502-416-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2564601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical