Provider Demographics
NPI:1669928024
Name:CRABB, CARISSA JANEL (LCSW)
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:JANEL
Last Name:CRABB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CARISSA
Other - Middle Name:JANEL
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2303 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-4954
Mailing Address - Country:US
Mailing Address - Phone:816-232-4417
Mailing Address - Fax:816-671-0961
Practice Address - Street 1:3608 FARAON ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3044
Practice Address - Country:US
Practice Address - Phone:816-232-4417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140350631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical