Provider Demographics
NPI:1851750889
Name:DAVID L CRENSHAW LMFT LCAS PLLC
Entity Type:Organization
Organization Name:DAVID L CRENSHAW LMFT LCAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:910-827-2445
Mailing Address - Street 1:4008 HALLIBURTON CV
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-3502
Mailing Address - Country:US
Mailing Address - Phone:910-827-2445
Mailing Address - Fax:910-793-6140
Practice Address - Street 1:1606 WELLINGTON AVE STE H
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7704
Practice Address - Country:US
Practice Address - Phone:910-793-6144
Practice Address - Fax:910-793-6140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC525106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty