Individual provider Active NPI

Laurence Terrell Crossland, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1376217497
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
259705 Issued in KY
Practice address
10300 Brookridge Village Blvd Ste 104
Louisville, KY 40291-4474
Phone
(502) 785-4322
NPI assigned
Aug 3, 2021
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7164 KY
Clinical Social Worker 1041C0700X 259705 KY Primary

Addresses

Primary practice location

10300 Brookridge Village Blvd Ste 104
Louisville, KY 40291-4474

Mailing address

10100 Elida Rd
Delphos, OH 45833-9056
Phone (419) 695-8010

Other practice location 1

1169 Eastern Pkwy Ste 3364
Louisville, KY 40217-1415
Phone (502) 813-8280

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
I20250109002054 KY Practitioner - Clinical Social Worker 3476081027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brock Family Therapy Center Inc.Group PAC ID 7315253416, 12 clinicians

Practice addresses (Care Compare)

10300 Brookridge Village Blvd
Suite 104
Louisville, KY 40291-4474
Phone (502) 785-4322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
259705KYMDClinical Social Worker
7164KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Family Therapy Center Inc. Multi-Specialty CurrentSince Dec 1, 2024 Accepting new patients
Wellspace Psychiatry LLC Multi-Specialty CurrentSince Dec 1, 2024 Accepting new patients
Specialized Alternative for Families and Youth of Kentucky, Inc. PastSince Aug 1, 2021 Accepting new patients
Specialized Alternatives for Families and Youth of Kentucky-Louisville PastSince Aug 1, 2021 Accepting new patients

Locations

10300 Brookridge Village Blvd
Ste 104
Louisville, KY 40291
Phone (502) 727-8697

9700 Park Plaza Ave
Unit 210
Louisville, KY 40241
Phone (502) 419-4289

Organizations & group practices 4

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1376217497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339056",
            "telephone_number": "419-695-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 BROOKRIDGE VILLAGE BLVD STE 104",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914474",
            "telephone_number": "502-785-4322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1169 Eastern Pkwy Ste 3364",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402171415",
            "country_code": "US",
            "telephone_number": "502-813-8280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROSSLAND",
        "first_name": "LAURENCE",
        "middle_name": "TERRELL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-03",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "7164",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "259705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.