MR. MOSES L CRENSHAW III BS NPI 1083019491

Counselor in Wilmington, DE

About MOSES CRENSHAW

Moses Crenshaw is a provider in Wilmington, DE. The NPI number assigned to this provider is 1083019491. The practitioner's primary taxonomy code is Counselor (101Y00000X). The provider is registered as an individual and their NPI record was last updated 4 years ago.

NPI

1083019491

Provider NameMR. MOSES L CRENSHAW III BS
Provider Location Address611 S VAN BUREN ST WILMINGTON, DE 19805
Provider Mailing Address611 S VAN BUREN ST WILMINGTON, DE 19805
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date10-28-2014
Last Update Date10-28-2014

Primary Taxonomy

Taxonomy Code101Y00000X
ClassificationCounselor
TypeBehavioral Health & Social Service Providers
Taxonomy DescriptionA provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.

Business Address

MR. MOSES L CRENSHAW III BS
611 S VAN BUREN ST
WILMINGTON, DE
ZIP 19805
Phone: (302) 494-2094

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Mailing Address

MR. MOSES L CRENSHAW III BS
611 S VAN BUREN ST
WILMINGTON, DE
ZIP 19805
Phone: (302) 494-2094

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.

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