Provider Demographics
NPI:1891328548
Name:CRUMBIE, NADESHA (LCSW)
Entity Type:Individual
Prefix:
First Name:NADESHA
Middle Name:
Last Name:CRUMBIE
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 1:1811 LYON RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4245
Mailing Address - Country:US
Mailing Address - Phone:862-290-0353
Mailing Address - Fax:
Practice Address - Street 1:2929 DELAWARE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3703
Practice Address - Country:US
Practice Address - Phone:910-456-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0142341041C0700X
NCC0150871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty