Provider Demographics
NPI:1336418938
Name:CRABB, STEPHANIE ELISE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ELISE
Last Name:CRABB
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 1:1220 PARK NEWPORT
Mailing Address - Street 2:APT. 322
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5007
Mailing Address - Country:US
Mailing Address - Phone:425-765-0642
Mailing Address - Fax:
Practice Address - Street 1:1666 N MAIN ST
Practice Address - Street 2:STE. 400
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-7417
Practice Address - Country:US
Practice Address - Phone:714-704-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA277971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical