Individual provider Active NPI

Michele Opal Crenshaw, LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1710651369
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016586 Issued in NC
Practice address
3117 Poplarwood CT Ste 115
Raleigh, NC 27604-1040
Phone
(919) 787-6131
Fax
(919) 571-2932
NPI assigned
Aug 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C016586 NC Primary

Addresses

Primary practice location

3117 Poplarwood CT Ste 115
Raleigh, NC 27604-1040

Mailing address

3125 Poplarwood CT Ste 203
Raleigh, NC 27604-6445
Phone (919) 787-6131

Other practice location 1

1423 Pitching Wedge Dr Apt 202
Raleigh, NC 27603-2875
Phone (849) 255-8085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240816001110 NC Practitioner - Clinical Social Worker 8123566536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C016586NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations Family Therapy of North Carolina, PLLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1710651369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT STE 203",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046445",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 POPLARWOOD CT STE 115",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041040",
            "telephone_number": "919-787-6131",
            "fax_number": "919-571-2932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 Pitching Wedge Dr Apt 202",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276032875",
            "country_code": "US",
            "telephone_number": "849-255-8085",
            "fax_number": "919-350-7687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "MICHELE",
        "middle_name": "OPAL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.