Organization
S. NICOLE CRAWFORD, LCSW, PLLC
Active
Other names
SNC Therapeutic Services
Organization subpart
No
Provider details
NPI number
Authorized official
SEDETRIA SUMERALL LCSW (OWNER)
(502) 777-2404
Entity
Organization
Contact information
Practice address
3715 BARDSTOWN RD STE 300, LOUISVILLE, KY 40218-2268
(502) 777-2404
(888) 607-7352
Mailing address
11135 FANTASY TRL, LOUISVILLE, KY 40229-5514
(502) 777-2404
(888) 607-7352
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
01/09/2020
Last updated
11/02/2023
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