Provider Demographics
NPI:1376971606
Name:MOTLEY-CROUCH, ALLISON (LCSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MOTLEY-CROUCH
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 1:209 N MAYSVILLE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1179
Mailing Address - Country:US
Mailing Address - Phone:859-404-7686
Mailing Address - Fax:859-498-8160
Practice Address - Street 1:209 N MAYSVILLE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1179
Practice Address - Country:US
Practice Address - Phone:859-404-7686
Practice Address - Fax:859-498-8160
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY12787177OtherCAQH
KY4074OtherLCSW LICENSE
KY6153OtherLICENSE
KY4074OtherLCSW LICENSE