Dru Fulton Crenshaw
Individual provider Active NPI Clinical Social Worker · Clinton, MS
NPI 1255765277 · NPPES record last updated Apr 9, 2024
Key facts
- NPI
- 1255765277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C7640 (MS)
- Practice address
- 313 Hunters Ridge Dr
Clinton, MS 39056-9660 - Phone
- (601) 357-0400
- NPI assigned
- Aug 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11846 | LA | MD | Social Worker |
| M7640 | MS | MD | Social Worker |
| C7640 | MS | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M7640 | MS | |
| Social Worker | 104100000X | 11846 | LA | |
| Clinical Social Worker | 1041C0700X | C7640 | MS | Yes |
Addresses
Primary practice location
313 Hunters Ridge Dr
Clinton, MS 39056-9660
Mailing address
313 Hunters Ridge Dr
Clinton, MS 39056-9660
Other providers in Clinton, MS
- Kinsey Costello
- Kimberly Course
- Jessie M Coy
- Anita Craft
- Creative Sisters Counseling LLC
- Jessica R Cronn
- Custom Care Pharmacy, LLC
- Custom Prosthetic & Orthotic
- George Cutrer
- David Brock Damon
All providers in Clinton, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.