Provider Demographics
NPI:1750648168
Name:CRASE, CYNTHIA (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:CRASE
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 1:268 E FRIEND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-8071
Mailing Address - Country:US
Mailing Address - Phone:606-506-5055
Mailing Address - Fax:606-506-5073
Practice Address - Street 1:268 E FRIEND ST
Practice Address - Street 2:STE 101
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-8071
Practice Address - Country:US
Practice Address - Phone:606-226-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100821660Medicaid
KY5132OtherLCSW