Individual provider Active NPI

Nicole S Crenshaw, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1255516787
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253979 Issued in KY
Practice address
2301 Goldsmith LN
Louisville, KY 40218-1018
Phone
(502) 458-1171
NPI assigned
Jan 3, 2008
Last updated
May 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X KY-5305 KY
Clinical Social Worker 1041C0700X 253979 KY Primary

Addresses

Primary practice location

2301 Goldsmith LN
Louisville, KY 40218-1018

Mailing address

5658 E Priddy Rd
Pekin, IN 47165-7612
Phone (502) 653-0721

Other practice location 1

130 Fairfax Ave Ste Llc
Louisville, KY 40207-4939
Phone (502) 653-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014003512 KY Practitioner - Clinical Social Worker 8022540194 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-5305KYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Counseling, LLC CurrentSince Sep 1, 2024 Accepting new patients
Wellspring Inc Past Accepting new patients
Father Maloney's Boys' Haven, Inc. PastSince Oct 29, 2023 Accepting new patients

Locations

130 Fairfax Ave
Ste Llc
Louisville, KY 40207
Phone (502) 653-7211

214 Breckenridge Ln
Ste 114
Louisville, KY 40207
Phone (502) 554-2439

802 Stone Creek Pkwy
Ste 1A
Louisville, KY 40223
Phone (502) 653-7211

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1255516787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5658 E PRIDDY RD",
            "city": "PEKIN",
            "state": "IN",
            "postal_code": "471657612",
            "telephone_number": "502-653-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 GOLDSMITH LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181018",
            "telephone_number": "502-458-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Fairfax Ave Ste Llc",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074939",
            "country_code": "US",
            "telephone_number": "502-653-7211",
            "fax_number": "502-416-0723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "NICOLE",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "KY-5305",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.