Provider Demographics
NPI:1750168100
Name:CRUTCHER, JEANEEN ROBIN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JEANEEN
Middle Name:ROBIN
Last Name:CRUTCHER
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 1:8 HUNTERS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:KY
Mailing Address - Zip Code:41008-8245
Mailing Address - Country:US
Mailing Address - Phone:502-525-0947
Mailing Address - Fax:
Practice Address - Street 1:8 HUNTERS RIDGE DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-8245
Practice Address - Country:US
Practice Address - Phone:502-525-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical